Older Adults and Exercise

We are all probably aware that exercise is good for us.  It improves our overall functioning, both physically and mentally.  It not only helps us live longer, healthier lives, but it also goes a long way in keeping us more independent as we age and allowing us to continue to participate in many of the activities that we enjoy.  It improves our mood, and it feels good for our body.  Exercise has found to be an effective treatment for many health concerns such as depression, diabetes, arthritis, and high blood pressure.  It can prevent or delay the onset of other health conditions as well.  And on the opposite end of the spectrum, those who are inactive are twice as likely to suffer from heart disease. They also have a higher risk of hospitalization and are dependent upon more medications than those who remain active throughout their lives. 

It is easy for anyone to make excuses about exercising.  We are too busy, too tired, unmotivated at times.  As we age we have even more excuses at our fingertips.  Aches and pains, lack of stamina, feeling the need to “take it easy”. These things add up and over time a lot of older adults become more inactive as they age, when it is actually a time in our lives that it is more important than ever to stay fit.  There are many moderate endurance activities that are recommended for older adults such as walking, swimming, dancing, tennis, golf, and bicycling. Make your exercise program a priority, and to help with this try to keep it interesting and fun.  Make it a social activity if possible. 

If you have not been active in a long time, start slowly and build up your endurance over time. Talk to your doctor before beginning any new exercise program and ask what is safe for you given any medical conditions, or to learn how to modify certain activities to avoid any problems.  If you smoke, are obese, or diagnosed with any chronic health problems such as heart disease or diabetes, your doctor can give you the best advice on which activities will be the most beneficial to you. Time is precious and we only get one chance at life, make yours the best that it can be! 

How to Plan the Perfect Picnic

August is National Picnic Month

Polly | September 19, 2012

If you're looking for a fun activity for seniors, a picnic is an easy, low-cost idea for an afternoon outing.

There are few joys as great as planning, and pulling off, the perfect picnic. Although picnics are sometimes thought of as old-fashioned they can actually be the simple, unique, and incredibly fun. Whether you are planning a romantic picnic, a family picnic, or an occasion-based picnic there are a few basic guideline that you should follow. While picnics appear effortless and nonchalant, a great picnic takes a little bit of planning and creativity. However, what a picnic does not require is a lot of money. This is what makes picnics a wonderful experience; you can plan a unique and fun picnic and not have to spend a lot of money doing so. Below are tips on how to plan the perfect picnic.

1. Pick a location

While you may want to start packing your picnic baskets right away one of the first things you should do is pick your picnic location. Depending on the type of picnic different locations could end up making all the difference. For example, a romantic picnic will benefit from choosing a location that holds special meaning to the couple, such as the flower field that they visited on their first date. A family picnic is made even more fun at a favorite park where there is a playground nearby for kids to play in. While an occasion-based picnic, such as a birthday picnic, will benefit from a location with beautiful scenery that is perfect for taking pictures.

2. Gather Your Supplies

If you don’t already own picnic baskets or picnic coolers then you should invest in some to make your picnic truly special. Picnic baskets make it easier to carry food, plates, utensils, and even wine glasses without things breaking or spilling. You can find a large variety of picnic baskets online including baskets that are extra large or that have special holders for wine glasses and come with plates and silverware.

3. Pick Your Food

Once you’ve looked at picnic coolers and found the perfect one for you the next step is to plan the food you are going to bring. Try to keep food simple. You don’t want to bring ice cream or foods that can easily spoil. You also want to steer clear of food that will need to be reheated. Instead pack cheese, fruit, bread, crackers, salad, cold chicken, sweets, and other foods that will be easy to pack and serve. Make a meal plan ahead of time so you aren’t digging in your refrigerator at the last minute for things to pack in your basket.

Planning a picnic is easy as long as you stick to a few guidelines. Once you pick the location, gather your supplies, and come up with a menu ahead of time you will be able to easily plan the perfect picnic that everyone will appreciate.

http://blog.picnicfun.com/how-to-plan-the-perfect-picnic/

4 Ways to Prevent Elderly Dehydration + Must-Try Summer Mocktail Recipes

by Dana Larsen

Our elderly loved ones need a little extra TLC during the hot summer months. Find out why dehydration increases with age and get valuable tips on keeping your favorite senior hydrated.

Senior dehydration is a common health issue that can lead to bigger problems if proper hydration is not made a priority, such as urinary tract infections and low blood pressure. Proper hydration helps to keep the body and vitals regulated. The University of Chicago Medical Center found that 40% of heat-related fatalities in the U.S. were among people over 65.

What Can Cause Dehydration?

There are a number of reasons the elderly are so prone to dehydration:

1. The ability to notice changes in body temperature typically decreases with age.

2. As people get older, body water content decreases.

3. Many medications the elderly take make them more susceptible to dehydration.

4. The elderly often experience diminished thirst; which leads to a reduced fluid consumption.

5. With aging, the kidneys have a reduced ability to concentrate urine and retain water during water deprivation.

6. Specific conditions, such as reduced swallowing capacity, decreased mobility, comprehension and communication disorders, as well as, decreased mobility and/orincontinence can contribute to dehydration.

7. Many seniors have underlying health conditions that make them less able to adapt to heat.

What Health Issues Can Dehydration Create?

There are some staggering statistics, compiled from The Department of Health, The Hydration for Health Initiative, The Adult & Geriatric Institute, European Review of Aging and Physical Activity, and the  Department on Aging, about dehydration in seniors.

Things you should know about dehydration:

• Dehydration has been associated with increased mortality rates among older adults

• Dehydration can accelerate or bring about emergency hospitalization and/or increase the risk of hospital stays

• Dehydration is a frequent cause of hospitalization of older adults and one of the ten most frequent diagnoses responsible for hospitalization in the U.S.

• Dehydration has been associated with many elderly health issues, including elderly confusion, impaired cognition, falling and constipation

• It is estimated that avoidable costs of hospitalizations resulting from dehydration is $1.14 billion, annually

What Steps Can Be Taken To Prevent Dehydration?

Fluid intake is key. Families and caregivers need to be cognizant about risks and plan ahead to make sure aging loved ones are properly hydrated. Here are some tips to help encourage fluid consumption and reduce the risk of elderly dehydration:

1. Offer fluids on a regular basis throughout the day.

2. Encourage 8 oz. of fluid intake every time the senior takes medication.

3. Keep water bottles and/or a water cooler available throughout the day wherever the senior is (for example, in bed, on the patio, throughout the house or at the senior living community).

4. Provide favorite “mocktail” concoctions (see below for some great recipes) or your senior’s favorite beverages (make sure they’re not caffeinated or alcoholic).

Tasty Recipes To Keep Your Elderly Loved Ones Hydrated

Strawberries and Coconut Water

Ingredients

To make 2 Strawberry Mocktails combine:

• 1 cup (250ml) of fresh coconut water

• 1 cup (250 ml) strawberries hulled and sliced

• 3 T of sugar syrup or agave nectar

Directions

1. To make the sugar syrup, boil sugar and water together in a ratio of 1:3 sugar to water until it thickens to a runny syrup consistency. Store in a jar for all future cocktail making.

2. Measure 1 cup of coconut water, either directly from a cut-open coconut or from a store-bought container (if you are lucky enough to live in an area that sells fresh coconut water in a bottle).

3. Combine the strawberries and sugar syrup and blend with a blender to desired consistency.

4. Serve with ice.

Get more information on making this delicious 

strawberries and coconut drink

.

Cucumber Lemonade with Basil

Ingredients

To make 3 to 4 Cucumber Lemonade treats combine:

• 1 English cucumber

• 3 C water

• 3 lemons

• 2 T sugar

• 1 small bunch basil

• 1 C soda water

Directions

1. Start by cutting your cucumber in half. Peel one half and cut it lengthwise (you can cut it in half again first if need be).

2. Scoop the seeds out and chop it into pieces.

3. Put the cucumber pieces in a food processor and puree until smooth.

4. Put puree in a fine mesh sieve over a container and push with a wooden spoon or spatula, extracting as much liquid as you can from the cucumber puree.

5. Fill a separate bowl or container with 3 cups water. Squeeze 2 lemons into the water and mix in the sugar.

6. Pour lemonade and cucumber juice into a pitcher or serving container. Slice remaining cucumber half (unpeeled) and remaining lemon and add to pitcher. Add basil, too. Refrigerate until chilled.

7. Serve with ice.

National Nutrition Month

Diabetes is a concern for many seniors. Proper nutrition helps with diabetes management. March is National nutrition month,  here is an article on nutrition for diabetes from the National Diabetes Association.                                    

24/7 Home Care Services

Your Mother has been in the hospital and it is time to discuss her discharge. The Doctor and Social Worker gives you an option. Either Mom needs to go to a facility (nursing home or assisted living) or have 24/7 round the clock home care. Mom wants to be home, so the discussion and search begins for the best homecare options. 

There are homecare options. Home Healthcare companies usually are unique in some ways. Some have different employee standards, some have dress codes, many bill in different ways. You want the agency which best fits your needs.

Abundant Blessings Homecare specializes in 24/7 round the clock homecare servcies. This program is managed a little differently because your needs are different. We do not want to turn your home into a facility. We aim to have the least amount of caregivers in your home and they work longer shifts. The cost is reduced as it is billed at a flat rate rather than an hourly rate. We provide a consistent small team of caregivers supervised and continuous communication with family. Our program offers continuity of care which provides you peace of mind. 

Senior Providers of Carroll County Networking Meeting

Upcoming Networking Meeting to be held

January 15th from 1:00 - 3:00 p.m. 

Tri-County CAP Resource Center

448 White Mountain Hwy, Tamworth

RSVP: info@abundantblessingshomecare.com

(603) 473-2510

Download flyer here

Seniors and Exercise

Are you or a loved one an active independent senior? If so, I’m sure maintaining that independence is important to you. Sometimes a fall can mean crossing that line to becoming disabled. There are many articles and resources available to assist with tips on fall prevention. These are all helpful and important. This article, however,  is to help you think about it a little differently.

Many young people fall, yet are not hurt at all. They do not break hips, back, etc. Why is that? Young peoples bones are dense and muscles are strong. If we do not exercise our bones thin and muscles get weaker. As we age, Osteoporosis and sarcopenia are often the main culprits of this. Most people are familiar with Osteoporosis, it is the thinning of bone tissue and loss of bone density. Its early stages are often without symptoms, yet this disease is, in most cases, preventable. Sarcopenia is a term used to define the loss of muscle and strength that occurs with aging. This too is preventable.

Another common complaint amongst seniors is fatigue. Many have perfectly normal blood work, but still experience unexplained fatigue. Often the fatigue is accepted as old age.      Fatigue such as this is also preventable and reversible.

Many people think that Seniors should take it easy, relax more, and get more rest. Actually the exact opposite is true. The key to stopping and even reversing fatigue, sarcopenia, and even osteoporosis is exercise. Naturally anyone thinking of starting an exercise program would be wise to consult with their Physician first.

Studies have proven over and over again that no matter what your age, exercise is good for you. Even in the very old muscle can be built stronger, and bones made denser. Two forms of exercise are recommended. Aerobic and resistance exercise. If you are just starting out, this can mean walking briskly. It will give you an aerobic workout and plenty of resistance for your muscles. After a few months of daily vigorous walking, you may be ready to visit a trainer or physical therapist for greater challenges and greater rewards.

Strong bones and muscles will make you more sure footed decreasing the chances of falling in the first place. You will have more energy and less fatigue. Regular exercise can also help your blood pressure, insulin sensitivity, cholesterol, body temperature regulation, aerobic capacity, lower body fat, and many more benefits await you. So what are you waiting for, talk to your doctor right away and start exercising!

If you are looking for more information on seniors and exercise you might also like this article:  "Older Adults and Exercise"

Family Decision Time

Is the following story familiar to you?

You have been the family caregiver for your aging mom for some time now. She thinks she is entirely independent and doesn’t need help, you know better. You have been helping with laundry, cleaning, and even help her organize her medications. Although mom is in denial that she needs any help, you are at your limit; physically, emotionally, and your time is stretched to the max. You would like to get some Homecare help, but you dare not bring it up, yet.

Then Mom falls. She is hospitalized for a while, and after is moved to the rehab. The doctor gives a choice of either a nursing home or 24/7 homecare, and Mom gets angry. She insists she is not going to a nursing home and the thought of having strangers in her home invading her privacy is unsettling to her. 

The solutions to situations such as this will be unique to each individual family. You as the family caregiver can greatly relieve any anxiety mom may have by showing care, concern, and calming her. Let her know you are there for her. Tell her, “let’s just try this and see how it goes”.

There are many options and programs available for families in situations such as this. Following are some resources to get you started. 

Being a Family Caregiver - You’re Not Alone

More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled or aged family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one.

The value of the services family caregivers provide for "free," when caring for older adults, is estimated to be $375 billion a year. That is almost twice as much as is actually spent on homecare and nursing home services combined ($158 billion).

In 43% of U.S. families, one sibling has the responsibility for providing most or all of the care for Mom or Dad, according to a survey of family caregivers. In only 2% of families in the U.S. the siblings split the caregiving responsibility equally.

The family caregiver is usually the adult child of senior parents who lives the closest. Between providing care, making decisions, and dealing with family members, the family caregiver has a stressful difficult job. This article is for the primary family caregiver, to help you in your role. Families come in all shapes and sizes, the situations are as varied as you can imagine. Many family siblings all have to work and have their own families, who will help? Many siblings may live a distance from Mom or Dad making being a part of caregiving difficult. If you are a family caregiver following are some tips.

The best advice is to plan ahead with your siblings and parents before care is needed. Discuss all possible situations and what Mom and Dad want. If it is too late to plan ahead, don’t worry. There are many resources available to help you. It is never too late to plan. Even if you have been caring for your Mom for many years, if you haven’t taken these steps, it is not too late.

Research – discover senior options in your area. This could be from senior centers programs, to assisted living options, to homecare services. There are family caregiver respite programs and senior day out services. Below is a list of resources to help you learn what options are available.

Have a family meeting – all siblings and parents should be at this meeting. Some may have to participate via telephone speakerphone, or skype, but  it is best to have everyone in the immediate family involved. If you are planning ahead, your parent(s) may be in their 70’s and may be mostly independent. This is the best time to make decisions and hear what they want. Planning ahead is less stressful and can be more productive. However, if you are in the midst of having to make imminent decisions a family meeting is still important. There are many things to discuss and consider at a family meeting such as; who has the power of attorney? If no one knows, or if this isn’t planned ahead, you may want to call an elder law attorney to help. An elder law attorney can help with many areas of senior planning and options. When the other family members they see what is involved in caregiving they may be able or willing to contribute something. Open caring communication is key at this stage.

Get outside help – Some families have trouble agreeing on what is best for Mom or Dad. If this is the case get a social worker, or care manager to join the family meeting. To have an unbiased third party helps more often than not.

Don’t neglect your needs – many family caregivers are overworked and stressed. The job of caring both for Mom and for your own needs can be overwhelming. Schedule time for yourself. Homecare agencies may be able to help with short term respite so you can have a day off, or take a vacation. There are many caregiver support groups available where family caregivers meet to encourage one another, share ideas, and what programs are available. Do not try to do this alone and do not forget your own needs.

Give your Mom or dad as much independence as possible. You may need to take the car keys away at some point, if so, find an alternative means for them to get around.  Make sure they feel they are making their own decisions. Every senior has care needs are at different levels. Do your best to help them feel as capable and independent as possible.

1. Caregiving in the United States; National Alliance for Caregiving in collaboration with AARP; November 2009

2. Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving; National Alliance for Caregiving and Evercare. March 2009 Page 2

3. Study conducted by The Boomer Project, included 711 adults in the U.S. and 383 in Canada ages 35-64 with living siblings or stepsiblings, who said they either currently provide care for a parent or older relative, or did provide care in the past 18 months.

Medication Wallet Card - New Resource

We have a new resource for you on the library page of our website; it's the Medication Wallet Card. We designed this card to be printed out and folded up to keep in your wallet. Fill in all the information and you will have a running record of your medications with you at all times. In addition it includes spaces for medication allergies, doctors contact info., blood type, emergency contact info., and more. When you print it, you will have to print both sides which will give you two copies of the Medication Wallet Card. You simply cut the paper in half the long way and that will give you the two cards. Then you fold the paper in half and then in half again and store in your wallet.

Keeping a list of your current medications with you at all times in case of an emergency is just one part of a good medication management program. We hope you find this resource helpful. 

Medication Wallet Card

Guest Speaking at Alton Senior Center

Today I had the opportunity to speak at the Alton Senior Center, where we discussed Senior Living Choices. Most seniors wish to remain in their own homes, however, as age related disabilities occur; assistance of others becomes a necessity. Most often a family member becomes the primary caregiver. Most adult family caregivers have their own families and jobs, etc. to attend to; making caregiving for their aging loved one challenging. Then there is the challenge of learning the skills necessary to accomplish this difficult job. In helping those with Alzheimer’s/dementia, mobility challenges, and other needs, it is important to know the skills to properly help.  This is why Abundant Blessings Homecare has skilled experienced professionals.  Abundant Blessings Homecare can help family caregivers have that much needed and deserved break. Whether your need is short term, only a few days a week, or up to 24/7 care we can help. We work with your schedule not ours. At the Alton Senior Center today we discussed these and other challenges seniors aging at home experience. We thank you all the Alton Senior Center for having us, you have a great program.

Activities for Alzheimers/Dementia Patients

• Place a bird feeder just outside a window so you can watch the birds. With spring being the nest building time of year, you could also hang a bag with some nest building materials and watch the birds take things from it for their nests.

• Cut pictures from magazines or greeting cards to make a spring themed collage.

• Set a pretty spring table and serve some spring type foods and tea.

• Make ice cream sundaes or floats.

• Paint, or sort, seashells

• Using a basic watercolor set, paint spring pictures.

• Plant some seeds in cups for the window sill, later you can plant them in the yard together.

• Blow bubbles.

• Make fruit salad

• Make Lemonade

• String cheerios or popcorn for the birds.

Senior Living Choices

Decisions regarding senior living options can be overwhelming for seniors and their families. There are stages in everyone’s lives when living situations must be considered. The earlier you and your loved ones discuss these choices, and how needs change over time, the less stress you will have. The following article can help you plan and make informed decisions so that these choices will be less overwhelming.

Living choices depend upon the health and well-being of the individual. These choices are usually in one of three categories: Independent living, Assisted living, and Nursing Care. For healthy seniors enjoying retirement, they are living independently. Independent living does not mean that you cannot have the assistance of others. It just means you do not depend on it. Many seniors living in their own homes, or in a retirement community, choose to use home care. There are many reasons for this, from companionship to help with cooking, cleaning, and running errands. This assistance provides the extra time to enjoy retirement life. As you age, your health and well-being changes. Consider your choices.

As age related health conditions develop loved ones may be concerned for your health and safety. Often seniors will be in denial that they need help. If there is a diagnosis of a disability or condition that limits their ability to care for themselves, assisted living should be considered. Conditions such as heart problems, Alzheimer’s disease, and a host of other age related disorders warrant this level of help. For those who want to remain in their own home, assisted living can be provided through a homecare agency. Homecare can provide help with daily living activities, from household chores to personal care assistance such as bathing, dressing, medication management, and mobility assistance. Many Independent living communities have an assisted living offering. Assisted living facilities may be a good choice if the senior cannot remain at home, yet does not need skilled nursing care. There are many choices available for your health, safety, and peace of mind.

If needs become such that skilled nursing care is required, a nursing home may be the best option. Nursing homes provide intensive, long-term medical care to seniors with serious health conditions in a fully staffed and monitored environment. This may be the best option if family lives a distance away. Many seniors, even with high needs and disabilities can stay at home with a combination of homecare Aids, home healthcare nursing visits, and family support. Determining your best option is the goal.

Different stages of life will cause you to confront different needs and options. We recommend discussing your needs and desires with family, those close to you, your doctor, and a Geriatric Care Manager. Whatever your hopes and desires are for your senior years, there are many choices. Aging in place, in the comfort and safety of home is now a feasible option for most. Whatever your stage of life, it is good to know you have choices.

For here for a PDF of Senior Living Choices chart.

Elder Abuse, Neglect, and Exploitation: Protect yourself or your loved one

The elderly often have to rely on others to meet their most basic needs. In some cases, the ones they rely on don't have their best interests in mind. Statistics tell us that about 9.5% of the elderly population is abused every year. One out of every 14 cases occurs domestically, usually within the victims homes, but abuse also occurs in nursing homes and other facilities.

Elder abuse is not just physical. It can include neglect and financial exploitation as well as physical, psychological, and sexual abuse. Physical Abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. This can happen even with good intentions.  For example, we have seen family members who force their elderly mother into the tub, because she has dementia and would not cooperate, causing minor injuries. When confronted, the family stated that they were just doing what the nursing home did.  This is often how physical abuse occurs. Psychological Abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. What is often simple family conflict can easily get out of control and lead to an elderly family member being psychologically abused. Financial Abuse or exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets.  Family members, neighbors, friends, hired caregivers, or anyone who is particularly close to an elderly person can manipulate them for personal gain. Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations to an elder, or the failure of an in-home service provider to provide necessary care. Being a caregiver is a hard and stressful job. Instead of seeking the help that is needed, many people simply ignore the problem, resulting in abuse.

We all have the right to be free from abuse, neglect, and exploitation. The types of abuse discussed above could happen to any of our community’s seniors. If you suspect any form of elderly abuse, it is important for you to report it. Without intervention, abuse almost always escalates. Because victims are often reluctant to report abuse, a person’s safety may depend on you recognizing and reporting it. It is far better to report a suspicion and be wrong, than to remain quiet while abuse occurs. It is important to know that more then two-thirds of elder abuse perpetrators are family members of the victims or close family friends, typically serving in the role of a caregiver. Elder abuse can be stopped, but only if it is reported.

If you or a loved one need homecare assistance, we recommend using a licensed agency rather than hiring privately. Homecare agencies must conduct criminal background checks, and BEAS  (Bureau of Elderly and Adult Services) registry checks. The BEAS registry is a database containing information on founded reports of abuse, neglect or exploitation of incapacitated adults by a paid or volunteer caregiver, guardian or agent. There are also individuals with a clear criminal background check who are in the BEAS registry. The NH BEAS registry can be reached at (603) 271-3269. Also, keep in mind, only criminals who get reported and charged have criminal records. Some homecare agencies and nursing facilities conduct pre-hire personality tests. These tests help determine if an applicant has a tendency toward certain types of crime or questionable behavior. We recommend using an agency that uses CQA (Caregiver Quality Assurance) www.selectacaregiver.com.

Questions to Ask Before Hiring a Homecare Agency

To obtain a license, a homecare agency must meet certain requirements for the state.

These requirements include:

• Criminal Background Checks

• BEAS registry check

• TB Testing

• Physical

• Training

• Liability Insurance

In addition to the above, we recommend asking your potential agency questions pertaining to things the state does not require of an agency, yet are important when considering care for a loved one.

These include:

• · How long has the agency been in business?

• · Are all caregivers employees or are they subcontracted?

• · What are their hiring standards?

• · What are the qualifications

• · What is the company dress code?

• · How much experience do the employees have?

• · What is the training and continuing education program for the employees?

• · Does the agency provide drug abuse testing for employees?

• · What is the range of pay provided to employees?

• · Does the agency conduct motor vehicle background checks? (this is especially important if the caregiver will be providing transportation)

• · Are your caregivers insured and bonded?

• ·Is there enough staff if at any time my loved one needs more hours of care (ie: 24 hour a day), or if a caregiver should call in sick do you have the staff for coverage?

• ·What are your hours of operation, how are phone calls handled during odd hours?

• ·What types of pre-hire screening do you conduct on your employees.

 Click Here for a PDF of Questions to Ask Before Hiring a Homecare Agency.

When Hiring In-Home Care - Be Informed

We often have people tell us they are considering hiring an independent caregiver for their homecare needs. Sometimes the person they are considering is a neighbor or a friend who has worked with the elderly or disabled at some point. All situations are unique and every need for homecare will have a slightly different solution, whether it be hours of need or type of services. We believe each family seeking homecare solutions should have the best care for their situation whether it be an agency or an individual, but we also believe each family in order to protect themselves and their loved one should be thoroughly informed when they hire. 

Here are a few things you should be aware of when weighing your homecare options. 

1.  Many families are not aware there are certain things which are required by law of any individual or any agency who performs home care / personal care services. For example: the state of New Hampshire requires all homecare agencies to be licensed but many are not aware that any individual performing personal care / homecare services must also be licensed. This state licensing was established to protect the individual. An agency must go through a thorough licensing process in order to obtain a state license, an independent caregiver must go through a similar process. This license is different than having an LNA certificate. An individual can have their LNA certificate and still not be state licensed. 

2.  Many families are not aware that when they hire a caregiver independently, the IRS then considers them an employer. We have had families call us who have hired caregivers independently and when the family no longer needs as many hours of coverage they let a caregiver go. The caregiver then goes to the unemployement office and the family receives a bill for back employee taxes. Taxes which must be paid by an employer include Federal, Social Security, Meidcare, and state taxes if you are outside of NH.

3. There is a state registry called the BEAS registry, we find there are many people who are not even aware this exists. This registry of the Bureau of Elderly and Adult Services is maintained to keep a registry of those who have abused, exploited or neglected elderly or disabled adults. Running a check of this registry is not the same as running a criminal background check. We have seen situations where someone is on this registry yet has a clean criminal background check. 

4.  Many families are not aware that a negative TB test is required of all home care employees employed by an agency or working independently. TB can be carried by an individual for years without signs or symptoms. Any caregiver you are considering hiring independently should also be tested for TB.

5.  Drug Testingfor illegal drug abuse or prescription drug abuse. Many of the homes in which homecare services are performed have prescription medications in them. In fact, medication reminders is often one of the primary needs of homecare clients. Yet when seeking homecare services, many families often are not aware of this potential problem. All homecare providers should be drug tested. 

6. Any homecare agency must provide, as required by law, Workers Compensation Insurance. In addition an agency provides Liability Insurance and Bonding. If you are considering hiring independently, your homeowners policy may not cover such things. Talk with your insurance agent and make sure your homeowners policy is going to cover any incidents which may occur. This is not the time to think "oh, nothing will happen", we live in a society which loves lawsuits and you put at risk your home and anything else you have worked hard for if there is an accident.

7. Other considerations.

• Sick Days: If homecare is something which you can not be without day in and day out, make certain you will have replacement if the caregiver should call out sick.

• Qualifications and Training. Be certain the individual you hire has experience and training in the skills you are asking them to perform. For example; just because someone has worked in a nursing home does not necessarily mean they have done transfer assistance. Transfering an individual to their bed or in and out of the shower requires specific skills and techniques and must be done correctly to avoid injury to both the caregiver and the client/patient.

• Transportation: If your caregiver will be providing transportation it is important that a motor vehicle background check be conducted prior to hire. Also, make certain your motor vehicle insurance will cover this situation or the caregiver is carrying their own motor vehicle liability policy. Our agency has a policy which will cover transportation of a client whether in the employees vehicle or the clients vehicle.

• Physical: All state licensed agencies and individuals must have a physical from their doctor stating they are medically cleared to do such work. You should make certain you obtain the same if you are hiring independently.

These above considerations are just a few of the things we believe every family hiring homecare services should consider. For more considerations you can download the following PDF document. 

When Hiring In Home Care - Be Informed

Facing the Realities of Dementia

When a loved one is diagnosed with dementia, more often than not it does not come as a surprise to their family. Dementia usually comes on gradually with plenty of warning signs. It is something that you certainly see coming, yet now that it has progressed to a point of diagnosis, and is causing some concern, what now?

Educate yourself. The more you can learn about the illness the more equipped you will be to help. Learning about dementia will help you know better how to help and what to expect as the disease progresses.

The most common forms of dementia include: Alzheimer’s disease, vascular dementia, Lewy body dementia, fronto-temporal and alcohol related dementia. By far the most pervasive is Alzheimer’s disease.

Resources available for families of those with dementia are plentiful. Such resources can help you learn about dementia, how and what to plan for, and how to cope with the realities and stress this illness can bring. Your first resource should be the Physician. He may refer you to a specialist such as a Neurologist to better diagnose and recommend care and treatment for them. Most hospital Social Workers and Care Managers will be familiar with resources that are available in your area, such as

• Alzheimer’s support groups and Homecare agencies. Here in New Hampshire, ‘Service Link’, a resource of the Department of Health and Human Services can be very helpful. They offer free information and referral services to help you find help.

Seek out and accept help. As dementia progresses more care and attention is needed. Some family caregivers may feel they do not need help due to a supportive family or a strong independent spirit to care for their loved one alone. However, we have seen too much stress and burnout, even illness, due to family caregivers trying to go it alone. You do not have to be a superhero and go it alone. We encourage you to connect with and line up support from the start so it's in place when you need it. Help can be found in many forms:

• Respite care, to be able to get a break without worrying. Many homecare agencies will provide services whenever you need a day off.

• Long-Term In-Home care can help if you are away at work during the day, or if your loved one lives alone. Homecare agencies can provide regular ongoing care on a schedule. This can allow your loved one to remain in their own home while provide the assisted living care they need.

• Adult Day Care facilities can be an option to provide relief and a break for you.

• Assisted Living Centers specifically for dementia related illness are available for those who cannot stay at home.

Detecting Early Stages and Signs of Dementia

Recognizing early signs of dementia is often difficult. Early diagnosis is important however, for the earlier dementia is diagnosed by a physician the more treatable it may be. The difficulty with diagnosing dementia is many of the early stage signs of dementia and Alzheimer’s are similar to normal aging. These signs can also be stress related or brought on by depression. To be familiar with the differences between normal memory loss associated with aging, and memory loss caused by dementia is important. While dementia is not a disease in itself, it describes a group of symptoms often associated with a disease or condition, such as Alzheimer’s disease.

A preliminary assessment can determine orientation to person, place, and time. Standard questions asked are: “What is your name?” “Where are you?” and “What time is it?” Although common in health care practice, these questions are not sufficient to determine dementia. Close family members, who know the loved one well, are often better equipped to determine if the persons’ orientation is “normal” for them. Sometimes family may be in denial, believing what is not normal to be normal aging. For these reasons we recommend family accompanying their loved ones to the physician. Below is a list to help you to recognize the early stage signs of dementia. Patience and a caring spirit are always best for you and your loved one.

If your loved one has any of these signs it is best to talk to your physician.

• Memory loss is the most common sign of dementia. Occasional memory loss may be a normal part of aging, but memory loss that is frequent and disrupts normal living is not. For example; if someone cannot remember the names of those closest to them, or where common things are located.

• Difficulty with familiar everyday tasks can be a sign of the early stages of dementia. This can include having trouble with personal care, cooking, cleaning, or using the telephone.

• Language difficulties may develop as an early warning sign of dementia. Showing difficulty in finding the right words, participating less in conversations, and having difficulty saying what is meant can all be language and communication issues related to dementia.

• Disorientation with familiar surroundings, such as in their own neighborhood or home, is often caused by a dementia related condition.

• Abstract thinking and solving problems may become difficult or impossible with dementia. They may have trouble following a recipe or keeping track of monthly bills.

• Poor decision making and lacking sound judgment even when the correct choice should be obvious is a sign. For example, choices such as lack of warm clothing in the snow.

• Misplacing things by putting them in inappropriate places is a common sign. Such as putting the telephone in the refrigerator.

• Changes in mood, behavior, or personality, is a common, and challenging sign of dementia. They may become depressed, anxious, frightened, irritable, or even aggressive.

No More Paper Social Security Checks Come March

As of March 1, 2013, all Social Security recipients will be required to set up direct deposit for their social security checks as opposed to receiving paper checks.

If these changes will affect you or a loved one, you should prepare ahead of time. Here's a link to an excellent article on the subject at CNN Money.

"No More Paper Social Security Checks Come March"

Are you a family caregiver who feels invisible? We see you.

If you think the above title is describing you, never fear, appreciation is here. We think you're incredible.

Over and over again we see family members caring for their loved ones in difficult circumstances and the emotional and physical drain is often visible. We understand that being a caregiver is pretty much an unappreciated job, making you the "invisible caregiver". We want you to know we see you there and we see the hours you put in without punching a clock. We want you to know we understand how difficult it is to see your loved one in the state they are in. Your patience, dedication, sacrifice, and compassion are without measure and we see.

You, family caregivers, are the unsung heroes. You, the family caregiver, you, the son or daughter, husband or wife who is dealing with the situation on a minute by minute basis and sacrificing so much, you are are our heroes and we wanted you to know. 

We want you to know it's ok to take some time and do something for yourself, in fact, not only is it ok, it's something you really should do (without any guilt trip either). 

In addition, we wanted to give you a reward...your very own caregiver certificate of appreciation. Go ahead and print one out for yourself or for a caregiver you know. Fill out your name and hang it on your fridge. Better yet, frame it, you earned it, you deserve it.

You, the unsung heroes.

Note: The first certificate is from us here at Abundant Blessings Homecare.  The second certificate is blank in the "from" section for you to fill out if you want to give it to someone from you. Both caregiver certificates are free to download.

For additional info on being a caregiver see 

• 10 Ways to Care for the Caregiver