A lawsuit has been filed against a nursing home in Aurora, Ill., and one of its patients, Sylvester Graves, after he allegedly sexually assaulted an older woman who lived there. According to the lawsuit, Graves beat the woman severely and sexually assaulted her in his room at Fox River Pavilion nursing home. The suit accuses the nursing home of failing to adequately monitor Graves and provide security of other residents.  Clifford Ward, Chicago Tribune

One of my colleague’s elderly mother recently had to be hospitalized for a brief period, and somehow got it in her mind that her children wanted to put her in a nursing home.  The adult children had simply suggested an extra day’s hospital stay since she seemed a bit confused.  They wanted to make sure she was just merely having a reaction to the anesthesia used during the procedure, and that she had not had a small stroke.

The mother was terribly upset by this and even now won’t seem to let go of the idea.  The reason she was so upset?  “Bad things happen to people in nursing homes,” she told her daughter.

As we can see from this article and many more, the mom was not inaccurate.  At the same time, this incident got the daughter thinking,: since Mom is getting up in age it is not out of the question that at some point an assisted living facility with a transitional unit for nursing care might have to be an option.

Knowing what I do for a living, she called me for suggestions.  I gave her some ammunition for interviewing facility directors, and things to look for,  but my primary recommendation was for she and her siblings to work with a Geriatric Care Manager, in order to ensure that Mom was going to be well taken care of.

As the population ages and grown children are faced with these decisions, involving an expert is the absolute best route in my opinion.  Thankfully, in this case the mom was still “fuzzy” for longer than a younger person would be after anesthesia, but at least the family now has a plan for the future if the need arises.

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• What is a Geriatric Care Manager? (vp-medical.com)
• Patient Money: Finding the Right Care for the Elderly (nytimes.com)

Geriatric care managers are typically registered nurses who are hired by private clients and/or their families.  The tasks of a geriatric care manager is much like those of a medical case manager.  The most common tasks include:

• Performing an in home assessment to determine the needs of the client
• Determine the client’s eligibility for social services, assistance with applying for those services and arranging the services.
• Arranging transportation to and from appointments and for activities of daily living
• Interviewing in home workers for assessment, arranging the services and monitoring the care
• Providing referrals to geriatric specialists and attending the appointment(s)
• Researching housing options and performing inspections of such
• Arrange and assist in moving the client from a home to other housing such as assisted living facility, nursing home, or retirement community
• Act as a liaison between the client and their family members by monitoring the client’s condition via home visits and phone calls and reporting the findings and concerns to the family members
• Verify that necessary services are being effectively and professionally delivered
• Analyze financial, legal and/or medical information and interpret it for the client and/or family members to better understand their options
• Work with an elder law attorney to reserve resources while obtaining the necessary services

Geriatric care managers work to provide information, but also peace of mind, particularly to family members who live far away from their aging relatives.  It is easy to become overwhelmed with the demands of daily life.  Add to that the daunting tasks of never-ending paperwork, making arrangements for assistance, coping with health problems, medication management and the aging process and you soon find you need help.  Contact your local case management association or contact your hospital discharge planner for recommendations.

What is your primary need for your loved on?  What services do you find most frustrating and need the most help with?

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The holiday season can be a joyous time of the year for families and friends, near and far.  But the events of the last two years and the aging of the baby boomer genre have placed us all in very unique circumstances.  As joyous as the holiday season can be, it can also be stressful and tiring, especially for our elderly.  We would like to share a few inspirations to help you deal with this holiday season.

1. The holiday season is meant for families, but it is also a time for remembrance.  There may be family members that have passed on, and a gentle walk down memory lane can a healthy way in dealing with loss while learning how to move forward into the next, and many years to come.  Remember, grieving is a healthy process for every one of all ages.
2. Some members of your family may be dealing with certain health issues, including memory loss, dementia, or Alzheimer’s.  The holidays and family gatherings can provoke powerful memories, or even inhibit moments of memory.  Be patient.  This can be the right time to remember what is important, and that is your family. Be accepting of change and advent of new, more exciting traditions.
3. Be careful of holiday cheer, as alcohol can have both impassive and passive effects on the elderly due to disease processes, and the medications they may be taking.
4. Provide areas of rest and relaxation.  The elderly may become more fatigued and have shorter endurance levels than last year.  Be cognizant of their needs, and provide space and time for rejuvenation.
5.  Sometimes keeping it small will be more beneficial and the economic challenges of the last two years has made it all but impossible to make this holiday season anything but small.  But small does not have to change the spirit of the holiday season.  What it does mean is more time to spend together and remember the events of Christmas past that have only made us stronger from one year to the next.
6. Have realistic expectations.  The parties and celebrations don’t have to be perfect.  As our families grow and change, traditions may need to change too.  Choose a few to hold on to, but be open to modifying others.
7. Plan ahead.  If an older family member tends to tire easily or if they are easily over-stimulated, limited the time they are included.

Remember, Christmas is not about what or how much is under the Christmas tree.  It is time to be with family, share the joy of the season, and to be thankful for the blessing you and your family experienced over the last year.  Be sure to acknowledge those blessing and pass them on for all Christmas’s to come.

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Below is a list of the top 50 hospitals in America that excel at and focuses on treating geriatric patients developed by US News and World Report.  While Arkansas is not currently listed, the medical center is working to change that with new grant money.  You can read about the project here.

Best Geriatric Care Hospitals

1. Ronald Reagan UCLA Medical Center, Los Angeles, CA
2. Johns Hopkins Hospital, Baltimore, MD
3. Mount Sinai Medical Center, New York, NY
4. Massachusetts General Hospital, Boston, MA
5. Duke University Medical Center, Durham, NC
6. Mayo Clinic, Rochester, MN
7. Yale-New Haven Hospital, New Haven, CT
8. UPMC-University of Pittsburgh Medical Center, Pittsburgh, PA
9. University of California, San Francisco Medical Center, CA
10. Cleveland Clinic, Cleveland, OH
11. Johns Hopkins Bayview Medical Center, Baltimore, MD
12. New York-Presbyterian University Hospital of Columbia and Cornell, NY, NY
13. Emory University Hospital, Atlanta, GA
14. University of Washington Medical Center, Seattle, WA
15. University of Michigan Hospitals and Health Centers, Ann Arbor, MI
16. University of Alabama Hospital at Birmingham, Birmingham, AL
17. Beth Israel Deaconess Medical Center, Boston, MA
18. NYU Langone Medical Center, New York, NY
19. Northwestern Memorial Hospital, Chicago, IL
20. Hospital of the University of Pennsylvania, Philadelphia, PA
21. Boston Medical Center, Boston, MA
22. Barnes-Jewish Hospital/Washington University, St. Louis, MO
23. Brigham and Women’s Hospital, Boston, MA
24. Rush University Medical Center, Chicago, IL
25. Shands at the University of Florida, Gainesville, FL
26. Washington Hospital Center, Washington, D.C.
27. Clarian Health, Indianapolis, IN
28. Methodist Hospital, Houston, TX
29. St. Louis University Hospital, St. Louis, MO
30. Hackensack University Medical Center, Hackensack, NJ
31. St. Francis Hospital, Roslyn, NY
32. Mount Sinai Medical Center, Miami Beach, Fl
33. Cedars-Sinai Medical Center, Los Angeles, CA
34. University of Chicago Medical Center, Chicago, IL
35. University of Miami, Jackson Memorial Hospital, Jackson, FL
36. Beaumont Hospital, Royal Oak, MI
37. Sarasota Memorial Health Care System, Sarasota, Fl
38. Aurora St. Luke’s Medical Center, Milwaukee, WI
39. Franklin Square Hospital Center, Baltimore, MD
40. University Hospitals Case Medical Center, Cleveland, OH
41. St. Luke’s Episcopal Hospital, Houston, TX
42. Union Memorial Hospital, Baltimore, MD
43. Mayo Clinic, Jacksonville, Fl
44. Lehigh Valley Hospital, Allentown, PA
45. Sentara Norfolk General Hospital, Norfolk, VA.
46. Christ Hospital, Cincinnati, OH
47. Tampa General Hospital, Tampa, FL
48. Stanford Hospital and Clinics, Stanford, CA
49. Abbott Northwestern Hospital, Minneapolis, MN
50. Loyola University Hospital, Maywood, IL

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There are many reasons one might consider the services of a professional care manager.  Nurse care managers like myself are often called in when medical concerns become an issue.  Other times a fall might prompt our assistance.  I have listed below the top ten reasons for referral.  Feel free to add your own.

1. You are concerned about your loved one’s safety in the home.
2. Medication and treatment plans are confusing.
3. You are overwhelmed by the demands of caregiving.
4. Your loved one has an unexplained weight loss that is not easily controlled.
5. There has been a recent emergency room visit.
6. Frequent falling.
7. Multiple hospitalizations or medical treatment.
8. There is no one local to assist the family member or monitor their health.
9. Activities of daily living such as bathing, grooming, housekeeping and nutrition are not being met.
10. There is concern that your loved one is not receiving adequate care in the assisted living facility or nursing home.

My role is to perform assessments and coordinate services for your loved one.  Each client is thoroughly evaluated and a personal plan of care is developed, outlining their needs and prioritizing them.  As a nurse I also identify risk factors and implement strategies to prevent their occurrence.  The favorite part of my job is acting as a liaison for concerned family members living in other areas.  I am oftentimes the eyes and ears and help bring families and solutions together.

If your loved one needs assistance or if you need help in determining solutions, contact our office today to learn more about geriatric care management services.

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• Patient Money: When Elder Care Problems Escalate, You Can Hire an Expert (nytimes.com)
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ABLEDATA: Provides information on assistive technology and rehabilitation equipment, including how to find and purchase it.  Also offers an online forum for consumers, caregivers and others to submit and read reviews of products and classified ads of equipment for sale. (800) 227-0216

http:/ / www.abledata.com

Able Project.org: A nonprofit organization with an online directory that allows people to research, compare, locate and obtain mobility and assistive products, such as wheelchairs, canes, walkers, bars and rails. (408) 263-8000

http:/ / www.ableproject.org

Alzheimer’s Association: Provides reliable information, care consultation and supportive services for dementia caregivers through state and local chapters. The website also includes an interactive tool, CareFinder, which helps families to:
• Recognize dementia care
• Plan and pay for care
• Communicate with care providers
• Find local support and resources

(800) 272-3900
http:/ / www.alz.org

AssistiveTech.net: Government-sponsored website with a directory of assistive devices and other products, which includes information about cost and vendors. (800) 726-9119

http:/ / www.assistivetech.net

Association of Jewish Family & Children’s Services (AJFCS): An online directory of AJFCS  member agencies throughout the country. Services include:
• Care management
• Chore services
• Adult day services
• Kosher meals on wheels
• Respite care

(800) 634-7346

http:/ / www.ajfca.org

CancerCare: Provides support services for anyone affected by cancer including limited financial assistance grants for:
• Transportation
• Child care
• Home care

Patient must currently be receiving treatment for cancer (800) 813-4673

http:/ / www.cancercare.org

Catholic Charities: Provides social services to individuals in need, including family support, respite care and home care services.

Eligibility varies by program (see website)

http:/ / www.catholiccharitiesinfo.org

Easter Seals: Assists children and adults with disabilities and their families by providing adult day services, including medical and social services. Children and adults with disabilities. (800) 221-6827

http:/ / www.easterseals.com

Faith in Action: Network of interfaith volunteer caregiving programs across the country. Volunteers shop, cook, drive or just check in on those with long-term health needs.

Eligibility varies by program (see website) (866) 839-8865

http:/ / www.fianationalnetwork.org/

Hospice Foundation of America: Provides information about end-of-life care. Its website includes a “Locate a Hospice” search which allows the user to search for hospice and palliative care programs, and a “Caregiver‘s Corner” that offers publications and tips on caregiving for persons near the end-of-life. See website for local contact information.

http:/ / www.hospicefoundation.org

Lutheran Services: Provides services ranging from health care to disaster response, as well as services for children and families and care for older adults. Eligibility varies by program (see website)

http:/ / www.lutheranservices.org

Meals on Wheels Association of America (MOWAA): Offers online directory of local meal programs across the country for adults who are elderly, homebound, disabled, frail, or at risk.

http:/ / www.mowaa.org

National Adult Day Services Association (NADSA): Online directory of NADSA member agencies throughout the country (including adult day services and adult day health programs).

(800) 558-5301

http:/ / www.nadsa.org

National Association for Home Care and Hospice (NAHC): Online “Agency Locator”  helps consumers to find and choose a home care provider in their state and local area to match their specific needs. Database consists of NAHC members, more than 20,000 home care and hospice agencies.

http:/ / www.nahc.org

National Association of Professional Geriatric Care Managers: Online directory of its members, who provide services throughout the country at varying fees. These professionals (nurses, social workers, etc.)  specialize in aging and elder care and can help families assess needs and plan suitable care.

http:/ / www.caremanager.org

National Center on Senior Transportation: Provides online directory of transit agencies and community transportation providers for older adults. A toll-free line is available to answer questions regarding transportation services for older adults. (866) 528-6278
http:/ / www.seniortransportation.net

National Hospice and Palliative Care Organization: Provides information about end-of-life care. Its online “Find a Provider” search allows the user to search for member hospice and palliative care programs for individuals who have advanced illness or have been considered terminally ill by a physician. (800) 658-8898
http:/ / www.nhpco.org

National Private Duty Association (NPDA): Online directory of home care agencies, both medical and non-medical, in 44 states.  Database consists of NPDA members.

See website for local contact information

http:/ / www.privatedutyhomecare.org

National Resource Center on Supportive Housing and Home Modification: Sponsored by the University of Southern California, the website features a section entitled “Home Modification for Caregivers” and an online national directory of home modification resources geared to help older persons remain independent.

http:/ / www.homemods.org

Senior Corps- Senior Companion Program: Provides assistance to frail older persons and adults with disabilities so they can live independently in their own homes or communities. Volunteers offer:
• Respite for caregivers
• Companionship to care recipients
• Help with various tasks and chores

Frail older adults and adults with disabilities

http:/ / www.seniorcorps.org

Shepard’s Centers of America: Some centers hold monthly meetings of education and support for those who care for older adults. Centers also provide:
• Respite care
• In-home visitors
• Home health aides
• Support groups
• Adult day care
• Information and referral

(800) 547-7073

http:/ / www.shepherdcenters.org/ memberCenters.aspx

United Way: Over 1,350 programs operating throughout the country to promote increased access to health care for disease prevention and treatment, and medical rehabilitations for people with disabilities. Services focus on under- and uninsured populations.

http:/ / national.unitedway.org

Visiting Nurse Associations of America (VNAA): Online resource helps consumers locate a VNA in their area. VNAs offer comprehensive home health care or personal care to individuals in their respective communities for a fee. The website includes tips on choosing a home health agency and information about insurance coverage. Services vary by agency but may include:
• Skilled nursing
• Home health aide services
• Rehabilitation therapies: physical, occupational and speech-language
• Medical social services
• Hospice and palliative care services

• Anyone requiring care – medical orders from a physician are usually required for care
* Individuals must pay privately. Medicare, Medicaid or private insurance may pay for the service if the care is medically necessary, depending on each payer’s eligibility requirements http:/ / www.vnaa.org

As promised, here are the national listings for resources associated with living arrangements, particularly as they relate to elder care.

Access to Health Insurance/Resources for Care: Online resource that provides information on low-cost and affordable health insurance, health care, and hospice. It is a free service from the Actors’ Fund of America’s Health Insurance Resource Center.
(800) 798-8447
http://www.ahirc.org

Benefits Checkup: An online service of the National Council on Aging to help older adults and their families determine their eligibility for and enroll in federal, state, local and private benefit programs including Medicare and Medicaid.
http://www.benefitscheckup.org

ClinicalTrials.gov: An online service of the National Institutes of Health with current information about federally and privately supported clinical trials in human volunteers to answer specific health questions. The website offers information about a trial’s purpose, who may participate, locations, and phone numbers for more details.
http://www.clinicaltrials.gov

DisabilityInfo.gov: Government site links to information and resources on a wide range of disability related topics, such as: benefits, civil rights, community services, health services and more. The site includes a state and local resources map which allows the user to locate disability related information/services in their area.
www.disabilityinfo.gov

Family and Medical Leave: The Family and Medical Leave Act (FMLA) is a federal law that allows employees to take up to 12 weeks of unpaid leave per year to care for themselves, or for a seriously ill family member, or for a new child without losing their jobs or health care insurance. Some states have additional benefits, such as paid family leave.
Eligible workers must:
• Work at companies with 50 or more employees at or within 75 miles of the work site
• Have worked at least 1,250 hours during the 12-months prior to taking leave
Workers can take leave to care for:
• An ill spouse, child, or parent (some states include additional family members)
• A new baby or adopted child
• Themselves when they have a serious illness Department of Labor:
(866) 487-9243
http://www.dol.gov/esa/whd/fmla

National Partnership for Women and Families:
http://www.nationalpartnership.org

Healthfinder.gov: Government web site for consumers that links to over 1,500 health-related organizations and provides consumer guides on issues including long-term care, Medicare, and nursing homes.
http://www.healthfinder.gov

LawHelp.org: Provides online directory of nonprofit legal services providers throughout the country. Anyone, with special attention on people living on low or moderate income.
http://www.lawhelp.org

Medicare: Medicare is a government health insurance program for adults age 65 and older, some people under age 65 with disabilities, and people with End-Stage Renal disease:
• Part A covers hospital costs as well as limited skilled nursing, home health and hospice care, without a monthly premium.
• Part B covers medical costs, such as doctor’s visits and outpatient care, to those who pay a monthly premium.
• Part D includes limited prescription drug coverage through private insurance companies for those who choose to pay a monthly premium.
Multiple requirements:
• U.S. citizen or legal resident
• Any adult age 65 or older OR any adult receiving Social Security Disability Insurance OR any adult with End-Stage Renal Disease or ALS
(800) 633-4227

Medicare Rights: Nonprofit organization that provides direct assistance to people with questions or concerns about Medicare. Information is provided about Medicare drug coverage, health plan options, and rights and benefits. Assistance is available online or by a telephone hotline.
(800) 333-4114
http://www.medicarerights.org

MedlinePlus – Go Local: An online resource from the National Institute on Health that helps consumers find health services by location and service type. Services include:
• In-home care
• Nursing homes
• Hospitals
• Support groups
• Hospice and palliative care
• Physicians
• Pharmacies
Also provides health and drug information for patients and family members.
http://www.nlm.nih.gov/medlineplus/golocal/index.html

National Association of County Veteran Service Officers (NACVSO): Provides assistance in obtaining veterans’ benefits and answers questions regarding rules and regulations concerning veterans. Wesbite provides directory of Veteran Service Officers across the country.
http://www.nacvso.org

National Clearinghouse for Long-Term Care Information: Government website offers practical information and options on planning for future long-term care needs.
http://www.longtermcare.gov/

Social Security Disability Insurance (SSDI): A monthly cash benefit from the federal government for people who are unable to work for a year or more because of a disability.
Multiple requirements:
• Have worked in jobs covered by Social Security
• Be disabled, according to Social Security’s definition of disability
(800) 772-1213
www.socialsecurity.gov

Supplemental Security Income (SSI):A monthly cash benefit from the federal government to meet basic needs for food, clothing, and shelter for low-income older adults and people with disabilities.
Multiple requirements:
• Age 65 or older OR Blind or disabled, according to Social Security’s definition of disability (any age)
• Resources (real estate, bank accounts, cash, stocks and bonds) cannot exceed $2,000 per person ($3,000 per couple)
(800) 772-1213
www.socialsecurity.gov

U.S. Department of Veterans Affairs (VA): Provides primary care, specialized care, and related minor medical and social support services to U.S. veterans, service members and their families. VA benefits and services include:
• Compensation
• Pension
• Health Care
• Vocational Rehabilitation & Employment
• Education & Training
• Home Loans
• Life Insurance
• Dependents & Survivors
• Burial
• A veteran OR
• An active duty military service member OR
• A member of the Reserve or National Guard
(800) 827-1000
http://www.va.gov

I am on a bit of a resources kick lately.  I find myself researching resources on a regular basis and thought why wouldn’t I share my treasures with others.  Besides it will be nice to review my own website to retrieve the information in the future rather than do the research all over again.

These resources are specific to Arkansas and are targeted to those still living and receiving care in the home.  National resources will follow.

Alternatives Program: Government programs assists low income adults with any type of physical disability maintain independence in the community by helping to pay for personal attendant care and home modifications.
Multiple requirements:
• Adults age 21- 64 with any type of physical disability
• Require nursing level of care
• Low income (Medicaid eligible) (800) 981-4457 or (888) 682-0044

http:/ / www.daas.ar.gov/ alternative.html

Independent Choices is an option of this program which allows care receivers to choose and hire their own service provider including a relative or friend who is neither their spouse nor their legal guardian to provide the care they need.
http:/ / www.independentchoices.com

Arkansas Area Agencies on Aging (AAA): AAAs offer aging services, including:
• Information and assistance
• Care management
• Nutrition services (i.e., Meals on Wheels)
• Legal assistance
• Services for family caregivers through the Family Caregiver Support Program (FCSP)

Anyone age 60 or older. (866) 801-3435
http:/ / www.arkansas.gov/ dhs/ aging/ aaamap.html

Arkansas Hospice: Non-profit organization provides hospice and palliative care services in Arkansas.   (501) 748-3333 (877) 257-3400

http:/ / www.arkansashospice.org

Arkansas Independent Living Council: A network of non-profit, non-residential, community-based centers, run and controlled by persons with disabilities that offer:
• Information and referral
• Peer counseling
• Care management
• Independent living skills training
• Individual and systems change advocacy
• Benefits counseling
• Employment readiness training
• Housing referrals
• Assistive technology services
• Legal aid

(800) 772-0607

http:/ / www.ar-ilc.org

Arkansas Rehabilitation Services (ARS): Assists residents of Arkansas with disabilities to obtain and retain employment. It provides information and referral services for independent living.

(800) 330-0632

http:/ / www.arsinfo.org

ElderChoices Program: Government program assists low income older adults who require nursing level of care to delay placement into a nursing facility by providing help to pay for in-home care services including:
•Care management
•In-home care
•Adult day care
•Chore services
•Home-delivered meals
•Respite care
•Personal emergency response system
•Supplemental services

Multiple requirements:
• Adults age 65 or older
• Require nursing level of care
• Low income (Medicaid eligible)

(800) 235-0002 OR (501) 682-2441
Independent Choices
(888) 682-0044

http:/ / www.arkansas.gov/ dhs/ aging/ elch07.html

Independent Choices is an option of this program which allows care receivers to choose and hire their own service provider including a relative or friend who is neither their spouse nor their legal guardian to provide the care they need.
http:/ / www.independentchoices.com

HomeCare Association of Arkansas: Association of in-home care providers. Its website offers a search tool that allows users to locate in-home care providers in their communities.

(501) 376-2273

http:/ / www.homecareassociationarkansas.org

Increasing Capabilities Access Network (ICAN): Program assists people with disabilities obtain assistive devices and remain independent in their community by providing services including:
•Information & referral
•Assistive technology demonstrations
•Option to borrow assistive devices and telecommunication equipment for a limited period of time
•Alternative financing options for the purchase of assistive technology devices

(800) 828-2799
http:/ / www.arkansas-ican.org

With the largest generation of Americans entering the latter stages of life coupled with our longer life expectancy, it is crucial that patient care is readily available. The Donald W. Reynolds Foundation has just announced that it has received grants totalling $33.4 million for the University of Arkansas for Medical Sciences’ (UAMS) Donald W. Reynolds Institute on Aging. The grants will be used to build four floors (55,000 square feet) at the facility as well as $3 million toward care giver training program that will be instituted at the regional centers in Texarkana, Pine Bluff, Jonesboro, and West Memphis.

UAMS provides several senior health services. The Donald W. Reynolds Institute on Aging has a comprehensive, multidisciplinary approach to the treatment of Arkansas seniors. The Longevity Clinic is one of the south’s largest primary care clinics specifically for seniors. U.S. News & World Report named the UAMS Department of Geriatrics to their top ten list for graduate programs for the past seven years. Other senior services include the Eye Institute, the Cancer Institute and the Myeloma Institute.

As  a nurse caring for the geriatric communication, fall prevention can mean the difference in a long life or a complicated hospital stay.  Whether you, yourself are a senior, or if you have senior loved ones, take a look at this post from the Mayo Clinic staff which addresses six ways in which to reduce your risk of falling.

photo credit: fish2000

You may feel you already know how to prevent falls, but take a look and you may be surprised at just how many things you have never considered before.  Isn’t it better to be safe than sorry?