Cuts in Home Care Put Elderly and Disabled at Risk

Cuts in Home Care Put Elderly and Disabled at Risk
  Leah Nash for The New York Times
In Portland, Ore., Ken Poe, above, says he could not afford to pay his home aides on his Social Security income. More Photos »
By JOHN LELAND
Published: July 16, 2010
HILLSBORO, Ore. — As states face severe budget shortfalls, many have cut home-care services for the elderly or the disabled, programs that have been shown to save states money in the long run because they keep people out of nursing homes.
Since the start of the recession, at least 25 states and the District of Columbia have curtailed programs that include meal deliveries, housekeeping aid and assistance for family caregivers, according to the Center on Budget and Policy Priorities, a research organization. That threatens to reverse a long-term trend of enabling people to stay in their homes longer.
For Afton England, who lives in a trailer home here, the news came in a letter last week: Oregon, facing a $577 million deficit, was cutting home aides to more than 4,500 low-income residents, including her. Ms. England, 65, has diabetes, spinal stenosis, degenerative disc disease, arthritis and other health problems that prevent her from walking or standing for more than a few minutes at a time.
Through a state program, she has received 45 hours of assistance a month to help her bathe, prepare meals, clean her house and shop. The program had helped make Oregon a model for helping older and disabled people remain in their homes.
But state legislators say home care is a service the state can no longer afford. Cuts affecting an additional 10,500 people are scheduled for Oct. 1.
“They yanked the rug out from underneath us,” said Ms. England, who lives on $802 a month from Social Security. “I’m scared. I’m petrified. I can’t function on my own. I took care of my husband for eight years. Already I’ve given up many of my freedoms. Now they’ve taken our dignity. I’d like them to try living in my body for a week.”
Her case manager, Brandi Lemke, shook her head. “This is not saving any money,” she said.
Ms. Lemke said she feared that Ms. England would “end up in the hospital because of the diabetes” and be in assisted living by the end of the year. “If she takes a fall,” Ms. Lemke said, “she may require more than assisted living can handle.”
Nursing homes here cost the state an average of $5,900 a month; home and community-based services cost $1,500 a month.
Other states have made similar cuts:
¶Florida placed 69,000 people on waiting lists for home or community services last year, and more than 5,700 of them ended up in Medicaid nursing homes.
¶Alabama cut housekeeping services — useful for people who can no longer do some cleaning tasks — for more than 1,000 elderly residents.
¶Arizona sliced independent living supports and respite programs for family caregivers.
¶Kansas, with a $131 million shortfall, will cut independent-living services for 2,800 people with disabilities in the next year.
In Illinois, providers of Meals on Wheels have stopped adding clients because the state was not reimbursing them.
“I’m not getting a cost-of-living adjustment, and now I’m not getting food,” said Joyce Plennert, 83, who is on a waiting list for Meals on Wheels in Palatine, Ill. “Now I’m worried my home services will be cut. Without that, I’d be in a nursing home, if I could find one with room.”
Colorado, Mississippi, Missouri, Nevada, New Jersey, New York and Texas have all made cuts or frozen spending at a time when the elderly population — and the need for services — is growing.
In California, which faces a budget shortfall of $19.1 billion for the 2010-11 fiscal year, Gov.Arnold Schwarzenegger’s office proposed eliminating adult day health care centers that serve 45,000 people and in-home supportive services that help more than 400,000 elderly, disabled or blind residents. The Legislature rejected these cuts but has not yet produced an alternative budget. The state already cut Alzheimer’s day care centers and assistance for caregivers.
Because Medicaid regulations require states to provide nursing home care to receive federal Medicaid money, legislators often have more leeway to cut from home services. Advocates for the elderly and the disabled worry that these cuts are just the beginning, because state ledgers tend to recover more slowly than the national economy.
“The situation is grim, and it’s safe to say that present trends are expected to continue,” said JoAnn Lamphere, the director of state government relations for health and long-term care for AARP. “Nearly every state has proposed cuts of some sort to Medicaid. Some might seem small, but it’s death by a thousand slashes.”
The cuts in Oregon have been particularly painful to people who work with the elderly, because for more than three decades the state has been a leader in rebalancing long-term care away from nursing facilities and toward the home. The cuts here indicate how fragile these services can be against states’ needs to reduce spending.
“I’m seeing in a matter of months 30 years of work go down the drain,” said Donald Bruland, the director of senior and disability services for the Rogue Valley Council of Governments.
The state spends more than half its Medicaid long-term-care dollars on home care and has a separate $13 million program for people who do not qualify for Medicaid; on average, states spend just 25 percent of their long-term-care budgets on home and community-based care.
Bruce Goldberg, director of the Oregon Department of Human Services, said the agency did not have an estimate for how many of the people losing home care would end up in assisted-living facilities or in nursing homes — or, if they did, how the state would pay for them.
“We’re in new territory,” Dr. Goldberg said. “Long-term care is a cobbled-together system with many holes, and they just got deeper.”
Last week, the Oregon legislature’s emergency board scheduled a session for Thursday to reconsider some of the cuts.
In Portland, Ken Poe, 66, requires assistance because of polio, which he got when he was 9. He has little muscle strength and requires oxygen constantly. The state provides 20 hours of care a month in his home.
Mr. Poe, a former pilot and flight instructor, lives as independently as he can, he said — he still drives, though he needs help getting to and from his car — but said he could not afford to pay his aides on the $1,300 a month he gets from Social Security. He often borrows money from a home credit line at the end of the month. Because of severe osteoporosis, he worries about falling in the shower without an aide.
“There are times when I’m struggling to get to the kitchen when I wonder how much longer I can do this,” he said. “But this is my comfort zone. It may look like a mess” — he gestured to cardboard boxes filling the living room — “but the boxes are my system for getting around. Moving to an assisted-living facility would bring on a depression.”
For states, having to cut the Medicaid programs is a double loss, because they come with matching dollars from the federal government. This creates state jobs and much-needed revenue.
Without these, said James A. Davis, a gerontologist at Marylhurst University and executive director of United Seniors of Oregon, “it really is a death spiral.”
“So often the programs to go are the early interventions that save money and keep people healthy,” Professor Davis said. “That comes back to bite you.”

Emergency Checklist for Seniors and Their Caregivers

How to be prepared for a crisis

Ronnie Friedland

Care.com editor

We hope we'll never need the information, but if there is an emergency with your elderly parent or relative, having this checklist readily available will make your life easier.

Health emergencies with our elders can often become complicated by the sheer number of medications, doctors, insurance coverage and degree of chronic or acute illness(es) involved. Below is a comprehensive list of information and documents to keep on hand, so you'll be prepared.

Senior Care Emergency Checklist

• Doctors' names, their specialties and phone numbers.
• List of all medications being taken and what the prescriptions are for (be sure to keep the information updated -- as the medications may change frequently).
• Medical insurance and prescription plans and identification numbers.
• Social security number -- many insurance companies won't talk to anyone without the patient's social security number.
• Durable power of attorney -- a legal document that gives someone the authority to handle legal and financial issues if your parent or elderly relative becomes incapacitated.
• Health care proxy -- a legal document that gives someone the authority to make medical decisions for your parent or elderly relative.
• Specification of your elderly parent's or relative's wishes about resuscitation orders. Do you know their wishes? Knowing this information before a crisis can be crucial to the way in which you handle the crisis.
• Basic financial records -- a list of assets, account numbers, names and contact information for financial advisors or bank representative.
• Names and addresses of people to notify in case of an emergency -- such as children, grandchildren, close friends and neighbors who might be able to help out.
• Names and contact information for local clergy, if your parent or elderly relative has a preferred religious affiliation.

This information should be placed in the home in an easy-to-find location, such as near the phone in the kitchen, or in another commonly used area, as well as given to another family member or friend who agrees to keep a copy of the information for you.

http://www.care.com/senior-care-emergency-checklist-for-seniors-and-their-caregivers-p1017-q14552.html

Learn About Senior In Home Health Care in Austin, Texas

Senior Helpers Provides Many services in the Austin, Texas area.  We provide a full array of Home Care services for seniors and the elderly living in this beautiful area.  Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.

If you need Home Care services in Austin, Blanco, Buda, Driftwood, Dripping Springs, Hye, Manchaca, Wimberley, and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company.

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Caregiving: Tips for long-distance caregivers

(MayoClinic.com) If you live far away from a loved one who needs care, you might wonder what you can do to help. Start by understanding options for long-distance caregiving, from gathering information and coordinating services to providing occasional respite for a primary caregiver.

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What is long-distance caregiving? Long-distance caregiving can take many forms. From afar, you might:

• Provide emotional support to a primary caregiver
• Coordinate services for a loved one, such as arranging for household help or in-home care or arranging a move to a nursing facility
• Manage a loved one's medical bills or records

You might also set aside time for occasional personal visits.
How can I keep on top of my loved one's care from long distance? You can take many steps to be an effective long-distance caregiver. For example:

• Get organized. Compile notes about your loved one's medical condition and any legal or financial issues. Include contact numbers, insurance information, account numbers and other important details.
• Schedule a family meeting. Gather family and friends involved in your loved one's care in person, by phone or by Web chat. Discuss your goals, air feelings and divide up duties. Appoint someone to summarize the decisions made and distribute notes after the meeting. Be sure to include the loved one in need of care in the decision-making process.
• Research your loved one's illness and treatment. This will help you understand what your loved one is going through, the course of the illness, what you can do to prevent crises and how to assist with disease management. It might also make it easier to talk to your loved one's doctors.
• Keep in touch with your loved one's providers. In coordination with your loved one and his or her other caregivers, schedule conference calls with doctors or other health care providers to keep on top of changes in your loved one's health. Be sure to have your loved one sign a release allowing the doctor to discuss medical issues with you — and keep a backup copy in your files.
• Ask your loved one's friends for help. Stay in touch with your loved one's friends and neighbors. If possible, ask them to regularly check in on your loved one. They may be able to help you understand what's going on with your loved one on a daily basis.
• Seek professional help. If necessary, hire someone to help with meals, personal care and other needs. A geriatric care manager or social worker also may be helpful in organizing your loved one's care.
• Plan for emergencies. Set aside time and money in case you need to make unexpected visits to help your loved one.

How can I make the most of visits with my loved one? Careful planning can help you effectively use your time with your loved one. For example:

• Find out what your loved one needs. Before visiting your loved one, talk to him or her about what tasks you might be able to assist with during your trip. Does your loved one need to go shopping or is there something at the house that needs to be fixed?
• Schedule appointments. Ask your loved one if you can accompany him or her on a doctor's appointment during your visit. This will give you an opportunity to discuss your loved one's health, medications and any other questions you might have. Take notes on the doctor's recommendations. Ask the doctor to suggest any helpful community resources. Consider making appointments with your loved one's lawyer and financial adviser, too.
• Look for signs of problems. During your visit, check to see how well your loved one is managing daily tasks. Is your loved one able to drive safely, eat regular meals, keep up with personal grooming and pay his or her bills? Ask your loved one's friends and neighbors if they've noticed any behavioral changes, health problems or safety issues.
• Set aside quality time. Watch a movie with your loved one or take him or her to visit friends or family. Offer to play a game of cards. Simple activities can help you and your loved one relax and enjoy your time together.

I feel guilty that I'm not there enough for my loved one. What can I do? Many long-distance caregivers feel guilty about not being able to do enough or spend adequate time with a family member in need of care. If you're feeling guilty, remind yourself that you're doing the best you can. It may be helpful to join a support group for caregivers. You might benefit from the tips of others, as well as the knowledge that you're not alone.

©1998-2010 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Senior Helpers is Hiring Caregivers!

Senior Helpers, Central Texas’ premiere In-Home Care Agency, Ranked #2 in Entrepreneur Magazines top new franchises category, is now hiring!!!

301 Hesters Crossing
in the Westridge Office Park
Suite 206B (middle Courtyard)
Round Rock, TX 78681
Fax 512-597-3109

Please Go to this link and fill out the application: http://seniorhelpers.com/location/4828/apply-online

Alternatively you may print out the application and fax or mail it to us:
http://seniorhelpers.com/files/4828/Caregiver_Employment_Application_MH.pdf


We will call you to set up an interview if your qualifications meet our requirements


Senior Helpers serves - Williamson, Travis, Burnet and Bell Counties


Senior Helpers provides in home, non-skilled services, that care for a variety of people with various needs and disabilities. Our mission is to provide a full range of private pay in-home services by trained and qualified staff in a professional, courteous, and caring manner. We offer our caregivers FLEXIBLE SCHEDULES

Caregiving is as rewarding for the caregiver as it is for the person receiving the care. Our caregivers have the support of our trained staff and we provide on-going state-of-the-art education. We provide our caregivers at the skills to ensure professionalism, enthusiasm, and compassion for seniors. We offer our caregivers consistent cases where they establish a relationship with the client and family. Caregiving in the home is very rewarding enabling our clients to remain in control of their own lives with you as their personal assistant.

We are currently looking for applicants with the following skills:

If you're compassionate towards the elderly and would enjoy the satisfaction of helping them remain independent while living at home AND are a licensed caregiver (CNA) or a qualified Home Health Aide, a caregiving opportunity may be for you!

We require at least 1 year of experience working with the elderly in a companion and/or personal care assistance environment and a valid driver’s license with a dependable mode of transportation.

We are anxious to help you put your skills to work in the personal care field. We have flexible schedules ranging from short visits to live-in cases. Come join our team to become a part of a new and rewarding career.

You may also visit our website at www.seniorhelpers.com/roundrock  to read about our agency.

What Is Alzheimers Disease?

What Is Alzheimers Disease?
What Is Alzheimers Disease?
Alzheimers Disease is one of the saddest and frightening diseases.  Over the course of several years, it progresses through stages similar to a child growing up...only in reverse.  We start as adults, able to think and remember.  Then, it becomes more difficult to remember recent things or to calculate even simple things.  As Alzheimer's progresses, we become less able to run simple machines (like TV's, Cars, Cameras) or to find our way around...we even tend to forget who are our children or friends.  Over time, we forget how to dress, brush our teeth, shower.  In the final stages, we forget how to feed ourselves or to control our bowel and bladder.  Here are some top-selling books to help you understand what Alzheimer's Disease is and how to manage it. 
Note:  After caring for my mother who had Alzheimers disease, I can tell you there is a redeeming quality of the disease.  As near as I could tell, once she was in the mid-stage of the disease, it didn't seem to bother her at all.  It's as if she "forgot" anything was wrong.  This seemed common to most of the people in the Alzheimers care facility where she lived the last few years.  They all seemed happy and well adjusted. 
Alzheimers Disease Signs And Symptoms:
If you take a look at the early stages above, you'll see the common signs.  If you suspect Alzheimer's see a doctor and ask him to do a blood test for Vitamin B-12 deficiency.  If there is no deficiency, get a referral to a Neurologist, who can test your thinking ability.  Don't just assume because you've had some memory lapses, it's Alzheimers disease.
Alzheimers Disease Treatment:
If you catch it in the early stages, there are drugs that can slow the disease, but no cures.  At some point, Alzheimers disease will make it necessary to have professional residential care.  It's best to plan things in advance during the early stages and find a quality facility acceptable to both the patient and the one who will be making the health care decisions.
Alzheimers Disease Self Help:
Follow a low fat, high protein diet with lots of fresh fruits and vegetables.  Get plenty of aerobic activity and exercise.  Make sure you're drinking enough water.  Supplement your diet with natural Multi-Vitamins and Multi-Minerals, along with extra doses of the following to strengthen your blood flow, mental ability and immune system:
Antioxidants; including Beta Carotene, Flavonoids, Lycopene,  Vitamin A, Zinc, Vitamin E, Vitamin C and CoQ10.
Organic Germanium; 300-450mg divided into 3 doses a day.
Fiber; 12-15 grams extra from vegetable sources or supplements.
Garlic; 3 cloves per day.
Omega 3; 3 per day, 1 at beginning of each meal.
Lecithin; taken with the Omega 3.
Selenium
Lipoic Acid; at least 200mg daily, split into 2-3 doses.
Vitamin B Complex
Gingko Biloba; about 240mg daily, split into 2-3 doses.
Always check with your doctor before making changes in your nutritional or exercise habits.
Complete Healing:
We both know there are no guaranteed cures, whether in medicine, nutrition, herbs or anything else.  Complete healing...including mind, body and spirit...is possible, from God.  If you want God's help with your health problem, go to Help From God.
Physical Health Issues Forum - Support group for people suffering from physical illness, whether acute, chronic or life-threatening...we're here for each other. 

http://www.way2hope.org/Illnesses/what_is_alzheimers_disease.htm