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Alzheimer’s/Dementia

Aging Parents, Alzheimer's/Dementia, Lauren Reynolds, Uncategorized / 10.08.2017

The 2017 Taste of Rancho Santa Fe benefits 10 Local Charities, said Lauren Reynolds, Founder of At Home Nursing Care and Co-Chair of the 2017 Taste of Rancho Santa Fe. At Home Nursing Care offers accredited quality home care in San Diego and Los Angeles. The Taste of Rancho Santa Fe event, taking place on Sunday, October 1, 2017 at the Inn of Rancho Santa Fe – hopes to raise more than $100,000 to benefit ten local non-profits. “Through our application and screening process, we picked non-profits which align with the Rotary core value of service over self – with an emphasis on under-served communities,” said Laura MacKinnon, President of the Rancho Santa Fe Rotary Foundation which is the charity arm of the local Rotary club. With 22 wineries/breweries and 10 restaurants committed already to participate in this year’s Taste of Rancho Santa Fe, the 5th annual, the event promises to be an elegant and festive event. Tickets are on sale now at www.tasteofrsf.org at $100 – and all of the net proceeds are distributed to the causes that participate. Organized and run by the Rancho Santa Fe Rotary Club, the event relies mostly on volunteers to keep overhead low, leaving more money for the 10 benefitting charities. Among those picked as a beneficiary of the Taste of Rancho Santa Fe this year is Cancer Angels of San Diego – which provides funds and resources for families struggling with cancer, such as Sergio and Silvia. The couple has three young children, and Sergio was diagnosed with brain cancer. Cancer Angels provided the family with financial assistance. “I have no words. It brings tears to my eyes because I am so grateful that they have helped us so much when we felt like we had no hope for our financial situation and still having to go through all this,” Silvia wrote of their assistance. Another beneficiary is the Eric Paredes Save a Life Foundation, which provides free heart screenings to youth ages 12 to 26 to detect heart conditions that can lead to Sudden Cardiac Arrest. Jacob Li, a student/athlete at Torrey Pines High School, is one of those students who attended a free Eric Paredes Screen Your Teen event at the request of his mother; only to find out he had an irregular heartbeat which required surgical correction. “A quick, painless ECG test of my heart saved my life,” shared Jacob. [caption id="attachment_2635" align="aligncenter" width="150"] Jacob Li - TB Basketball[/caption] After undergoing surgery, he’s back on the court and is feeling healthy. His mother, a Diana Li, is now a board member of the Eric Paredes Save a Life Foundation. “As a parent of a teen found at-risk, I am beyond thankful for this free, lifesaving resource. Don’t wait, register your kids today. It could just save their life,” she said. Learn more at epsavealife.org. Money raised at the 2017 Taste of Rancho Santa Fe will help both...

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Aging Parents, Alzheimer's/Dementia, Lauren Reynolds, San Diego Caregivers, San Diego Home Care / 10.07.2017

Denial is a powerful self-preservation tool - it helps to keep us hopeful and moving forward in bad situations. But denial of a parent's or client's lack of capacity with respect to credit cards and money is the perfect backdrop for financial fraud. Lack of financial capacity requires some sort of action to keep people safe. As providers of in home care, we see it all the time, a lady with "senior moments" in her 80's who is not "diagnosed" with dementia - so her family looks the other way while she pays bills late, uses her credit card to purchase home shopping network items daily or gives large financial gifts to relatives. I've had a client, a wonderful retired Judge who was 93, insist he hadn't paid SDG&E when in fact; he'd paid the same power bill numerous times. His daughter didn't want to interfere with his "independence". We recommend re-loadable debit cards to all of our home care clients, the kind that give daily or weekly spending alerts that can be monitored by a trusted designee. Our agency offers a card to our clients, and for non-clients, I recommend the Truelink Card. I'm always surprised that those who need it most turn it down because "Dad said no." In one case, Dad was a retired physician not diagnosed with Alzheimer's because his fellow physicians simply didn't want to label him with the disease. He carried multiple credit cards, one with a $60,000 limit. He gave gifts as well. It's very hard for a family member, fiduciary or power of attorney to insist that an elderly person is not making good enough decisions to stay in control of their finances. But taking control away from someone who can't monitor money, bills, bank and credit accounts is a crucial step towards protecting those we love and those we are caring for. If taking over entirely is out of the question – consider negotiating with the elderly person to have a second set of eyes on accounts – someone responsible to assist with review of charge card bills, etc. Have a no gift rule unless certain conditions met, including having all gifts in writing signed by the giver, receiver and a witness or responsible party. We have a policy that any gift over $25 must be approved in advance by the agency – to protect our clients, our caregivers and our reputation. If the elderly person uses credit cards, limit the number of credit cards in the house, there is typically no reason that someone elderly needs three or four credit cards. Fewer cards means less to review. Have petty cash in the house, along with a log to track cash expenses. Make sure receipts are kept and reviewed by someone regularly. Finally, never have a caregiver, housekeeper or neighbor help with paying the bills or help with banking. Hire a bookkeeper or...

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Aging Parents, Alzheimer's/Dementia, San Diego Home Care / 10.07.2017

During June and July, as in home caregivers logged onto Facebook or Instagram - attorneys used a sponsored ad like this one pictured to lure the potential claimants into exploring their legal options against their employers. The ads ask questions of in home caregivers like, "Are you a home health aide? Are you being paid correctly?" With a simple click of the "Learn More" button, in home caregivers are connecting with attorneys who are aggressively going after companies and household employers who are violating California's often tricky wage and hour laws. It's a reminder to always make sure in home caregivers are paid correctly for all hours worked. This is necessary whether you have one employee, or 100 employees, whether you are working with a full service agency such as ours, At Home Nursing Care, or if you are hiring someone directly. Caregivers are not independent contractors in California, meaning all labor rules apply: sick time, pay for sleep time overnight, overtime after 9 hours in a day, 40 hours in a week, proper documentation on pay stubs, and so on. Make sure you are working with an agency that follows the rules to avoid co-employment liability. Not knowing the rules won't save you or your clients in court. And with social media, bad news travels fast. Give us a call if you are concerned about a private hire or "registry" situation. Our agency has signed meal waiver forms if we need in home caregivers to have paid on-duty meals. We make sure our caregivers don't engage in work that eliminates the personal care attendant exemptions that are very important in California’s Wage Order 15. The exemptions allow caregivers to not get regular meals and breaks if certain conditions are met. Some examples of easy ways to run afoul of Wage Order 15 is to have the caregiver clean an entire house or cook meals for the client and guests. Some registries and private employers still believe it’s okay to have a caregiver stay in a house 24 hours a day, and not pay overtime, or to deduct sleep time from pay. All of those practices will give an attorney a reason to write a demand letter or flle a claim. People who are in positions of influence over the caregiver, such as fiduciaries or accountants who cut checks or set schedules – may face a co=employment liability for any wage order violations, another reason to vet the service providers you engage. At Home Nursing Care is a licensed and accredited full –service in home care company which employs all of our in home caregivers. Our founder, Lauren Reynolds, sits on the board for the California Association for Health Services at home and she stays aware of the latest legal developments and compliance issues. We treat our employees as well as we possibly can, not just that's the law, but because it's the...

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Aging Parents, Alzheimer's/Dementia, Lauren Reynolds, San Diego Caregivers, San Diego Home Care / 03.06.2017

Making an educated choice about hiring in home care requires knowing the rules, the risks and how to mitigate them. This applies to families and professionals, such as fiduciaries - advisers hired by clients or appointed by the courts to oversee a person's financial, health and living affairs. Fiduciaries have an added potential liability in that they may be considered "co-employers" if they exercise any supervision or direct any of the care being provided in the home. This was the theme of a presentation given by At Home Nursing Care founder Lauren Reynolds and attorney Elizabeth Murphy at the 22nd Annual PFAC (Professional Fiduciary Assocation of California) Conference in San Francisco. It's a conference dedicated to giving fiduciaries the tools to protect seniors and the vulnerable. [caption id="attachment_2568" align="alignleft" width="224"] Attorney Elizbeth Murphy with AHNC Founder Lauren Reynolds[/caption] The Need: The number of people using nursing facilities, alternative residential care places or in home care services is expected to jump from 15 million in 2000 to 27 million in 2050. Among people who reach age 65, more than two-thirds will need long term care in their life time, and an American turning 65 years old today will incur $138,000 in future long term care costs such as in home care. The most common diagnosis for residents of Nursing homes is Alzheimer's/Dementia. The diagnosis most commonly seen for in home care is diabetes. The Rules: Since January 1, 2016, home care providers have required a license under the Home Care Services Consumer Protection Act. There are two licenses that apply - a non-medical home care license issued by the California Department of Social Services (CDSS), or a home health agency license issued by the California Department of Public Health. Our agency, At Home Nursing Care, has both licenses. Under the CDSS license, home care aides must be registered, which includes a background check that goes backwards indefinitely, in sharp contrast to the more established practice in California of going back 7 years for a criminal clearance. The requirements also include a TB test and initial and annual training. The unintended consequence of this requirement has been a shortage of qualified caregivers to provide in home care. Many aides cannot pass the background test due to mistakes they made 20 to 30 years ago, such as a DUI or shoplifting as a teenager. So far 7,700 in home care aides have requested "exemptions" from the CDSS rules. Home Care Providers have been requesting that the CDSS change their rules because so many aides have now gone underground, working privately under the table with little protections for seniors. Many previous home care companies are now calling themselves "employment agencies" or "referral services" to get out of having a license at all. Also - the CDSS license does not require that home care providers conduct any supervision of the aides that they place with clients. In contrast, under the CDPH...

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Aging Parents, Alzheimer's/Dementia, At Home Care Solution, Caring for Elders, Lauren Reynolds, North County Home Care, San Diego Caregivers, San Diego Home Care / 24.08.2016

[caption id="attachment_1886" align="alignleft" width="150"] Client with home care needs and her loyal caregiver.[/caption]   Home care needs are inevitable for most of us, and planning instead of simply reacting helps promote a safer and less stressful home care experience for family members.  At Home Nursing Care is here to help with your home care needs. It's been called the Silver Tsunami, a burst in the number of elderly individuals and as a result, an increase in home are needs.  The Silver Tsunami definition is: a dramatic increase in the number of Americans who are 65 years or older.   Due in part to birth rates (the baby-boom), medical and scientific advancements, and more people are living longer. For the first sixty years of the 20th century, life expectancy grew by about 2.5 years.  But from 1960 to 2007 - life expectancy expanded by a whopping 4.2 years.  Currently, anyone fortunate enough to hit 65 has an average life expectancy of 18.6 more years. Keeping on the statistics train, 1 in 8 Americans is now 65 or older.  That segment currently makes up 12.9% of the population, but it will jump to 19.3& of the population by 2030, according to the US Department of health and Human Services. Many older people live alone.  Since older women outnumber older men and have longer live spans, half of all women aged 75 and older live alone. [caption id="attachment_1211" align="alignleft" width="150"] Loren is the exception - this home care client lived to nearly 103![/caption] In California, 25% of all seniors live by themselves, and about of third of those seniors have some form of disability. Being able to age comfortably, either in place or in a suitable assisted living environment, takes some planning, especially financial planning.   A recent AARP study found that 31.6 % of seniors have experienced a substantial decline in their home's value over the last three years, and a quarter of all seniors have exhausted their personal savings. Paying for in-home care, such as the care offered by my company, At Home Nursing Care, can feel out of reach for some seniors.  Those with good long term care policies experience less stress when hiring in-home help.  I know of a 60 year old man who pays $300 a month for his long term care insurance.  His father had Alzheimer's disease, so this man worries that within a couple of decades he'll need substantial home care.  His policy will currently pay $300 a day for care, an amount that will rise over time.  That amount should cover his needs, whether he chooses a live-in caregiver in his home or a specialized memory care community. Reverse mortgages are another option for seniors with limited cash reserves.  They are available to people 62 or older who own their homes.  The amount of money available is based on age, current interest rates and a home appraisal.  The draw-back is the cost/fees involved, so be sure to consult a financial planner and someone experienced with reverse mortgages.  Beware of potential scams. Home care clients are especially vulnerable to the...

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Alzheimer's/Dementia, Caring for Elders / 06.04.2016

[caption id="attachment_1934" align="alignleft" width="1024"] At Home Nursing Care Caregivers Becoming Physicians[/caption] [caption id="attachment_1941" align="alignleft" width="1024"] Buena Suerte! Good luck to our wonderful caregivers becoming doctors![/caption] At Home Nursing Care salutes our caregivers becoming family practice physicians. In our Culver City At Home Nursing Care branch, we held a breakfast send-off celebration to recognize four wonderful and dedicated caregivers who are well on their way to becoming  family practice physicians. Yoel is a physician from Cuba who immigrated to the United States under a special visa for Cuban professionals.   He and his wife, Alibet, also a physician from Cuba, took positions as caregivers with At Home Nursing Care while they attended a special UCLA program for foreign doctors. Both were licensed physicians in Cuba, but they needed to attend trainings and finish a credentialing program here in the United States. Yoel's 92 year old client was thrilled when he heard Yoel had been accepted into a Family Medicine Residency outside of Bakersfield, even though it means losing the future doctor as a caregiver. "He is wonderful," said 92 year old Charles, "he will make an excellent doctor for people like me." (We found a wonderful new caregiver for Charles, but Yoel will be missed!) Alibet, who is finishing her credentialing and has been taking English lessons since she first began working with At Home Nursing Care nearly 2 years ago, is hoping to also start a residency program near her husband.   She provided 24/7 care to an elderly dementia client and had great reviews.   The couple is moving from Culver City to Hanford, North of Bakersfield. "It's amazing to get these educated and dedicated future doctors and have them work inside the homes of clients they will someday serve medically.  It gives them valuable perspective that will improve care in general," said Adriana Beischl, District Manager for the At Home Nursing Care Culver City Office. Yoel and Alibet have already referred more of their colleagues to apply with At Home Nursing Care.  We are honored to have their colleages join us and we wish Yoel, Alibet, and their colleages best wishes and good luck!   [caption id="attachment_1935" align="alignleft" width="1024"] Enjoying breakfast[/caption]          ...

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Aging Parents, Alzheimer's/Dementia / 20.05.2014

We are very grateful to our wonderful quality in home care clients who reacted quickly and reasonably last week when 11 different fires broke out across San Diego County. In all, emergency responders sent out 125,000 evacuation notices as more than 10,000 acres burned. Many of our At Home Nursing Care clients had to be quickly moved for their safety. "I’m grateful to Director of Operations Chelsea Kennedy and Caregiver Manager Denise Helmstetler who turned our office into a command post," said Lauren Reynolds, founder of At Home Nursing Care, a leading provider of quality in home care across San Diego County and West Los Angeles County. "They worked long days and gave our clients and employees all the help and support needed to stay out of harms way," Reynolds said. [caption id="attachment_1434" align="alignleft" width="150"] Chelsea and DeniseBest In Home Care Managers[/caption]   Kennedy and Helmstetler put a map on the wall and then marked where all of our employees and clients live.  Then they monitored emergency announcements and news reporting to see which clients should be moved during the fire evacuations in San Diego. Supervising Nurse Denise Callas activated our emergency disaster plan for our most medically fragile clients. When the smoke cleared, we had 4 clients and 4 employees evacuated. Thankfully, everyone is fine, except for one employee whose apartment building was damaged.  Her belongings are smoky. Unfortunately, we expect this fire threat to continue through the beginning of November. It’s a good time to give some extra thought to emergency plans, such as places where dependent elderly relatives should be taken during evacuations. The shelters are often not an option, as our dementia clients would not fare well in such a confusing atmosphere.  Perhaps think of nearby relatives or friends or hotels as an option.  The situation can change quickly, so have a couple options in mind. We also gave out recognition to employees who went above and beyond to provide quality and emergency in home care,  including working extra hours under pressure. Two of the employees recognized were Olga and Jennifer, long time employees who are part of our Care Ambassador program. [caption id="attachment_1433" align="alignright" width="150"] Olga and JenniferQuality In Home Care Providers[/caption] Thank you to everyone who helped and thank you to the many first responders and firefighters who kept these 11 fires from causing even more damage. At Home Nursing Care provides quality in home care to those facing a loss of independence due to age or health related factors.  We are dementia care specialists and we are licensed by the California Department of Public Health to offer nursing in the home.  We help you live a better life at home.  ...

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Aging Parents, Alzheimer's/Dementia / 03.05.2014

At Home Nursing Care is proud to support the mission of PFAC, the Professional Fiduciary Association of California.  This group aims to help the elderly and vulnerable by providing impartial fiduciary services, such as administering the trusts and finances for people who can no longer manage their affairs due to age or  health related factors. This is the second year that At Home Nursing Care has sponsored the PFAC annual conference as an exhibitor.   More than 700 people attended, including fiduciaries, attorneys who specialize in elder law, trust attorneys and accountants. [caption id="attachment_1384" align="alignleft" width="1024"] Lynda Clerke, Lauren Reynolds, Adriana Beischl at the At Home Nursing Care table[/caption]                 At Home Nursing Care can help professional fiduciaries by providing high quality in home care with employees who are screened, bonded, insured and supervised.  As a full service agency, we take full liability for all payroll taxes, worker's compensation insurance and following ever changing labor codes.  We are BBB Accredited, and we are certified by the California Association for Health Services at Home and the American Board of Home Care.  We are also members of PFAC. "We want to partner with professional fiduciaries that share our value of honest, compassionate service that enhances people's lives," said Lauren Reynolds, Founder/Administrator of At Home Nursing Care.  At Home Nursing Care also provides free continuing education for fiduciaries with meets state regulatory criteria. By attending the conference, our managers, including Lynda Clerke, who handles community relations, and Adriana Beischl, who is Operations Manager of the LA office, both learned the various challenges fiduciaries face while administering trusts.  We also learned which pitfalls lead to the most actions taken against fiduciaries. At Home Nursing Care provides hourly, daily, or 24/7 care of clients throughout San Diego county and West LA and South LA.  We can help with companionship, constant safety monitoring, bathing, dressing, meal preparation, activities, and our licensed medical services include providing LVN's or RN's to work in our client's homes.  We are licensed in San Diego County by the California Department of Public Health. Contact At Home Nursing Care to see how we can enhance the life of someone you love with quality in home care you can trust. Visit us online at athomenursingcare.com, or call us at 760-634-8000.    ...

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Aging Parents, Alzheimer's/Dementia, At Home Care Solution, Health Care Reform, North County Home Care, San Diego Caregivers, San Diego Home Care / 13.01.2012

A recent USA Today article states that there is an increase in seniors living over the age of 90.  According to author Haya El Nasser “The number of people living to age 90 and beyond has tripled in the past three decades to almost 2 million and is likely to quadruple by 2050”. Seniors who live longer generally have some sort of disability or need help at some level of living. Sandy Markwood, CEO of the National Association of Area Agencies on Aging, indicates that the focus needs to be on being able to help these seniors live at home as long as possible as nursing home cost could rise to average $72,000 a year. Long Term Care at any level, in the home, assisted living or nursing home can add a tremendous cost to seniors and their families. Government Programs Only Pay For About 16% Of Long Term Care Government programs such as Medicare, Medicaid and the Veterans Administration will cover the cost of long-term care under certain conditions. Medicare will cover rehabilitation from a hospital stay or limited care at home if there is a skilled (medical) need. The Veterans Administration will cover the cost of nursing home care indefinitely if the veteran is at least 70% service-connected disabled. The VA will also cover other forms of home-based or community-based care if there is a medical need. Medicaid will cover both medical and non-medical related long-term care but in order to qualify for Medicaid a person has to have less than $2,000 in assets and income that is insufficient to pay the cost of care. Funding Long Term Care with your Life Insurance Policy Drawing cash from life insurance or changing a life insurance policy should only be done after reviewing with an expert advisor.  Loss of the policy and death benefit could prove to be a detriment.  If, however you have accumulated cash in a life insurance policy and no longer need the coverage you may consider using the cash for long term care or purchasing a LTC rider to your current policy. New insurance products are being developed to cover both life insurance and long term care insurance. ElderLawAnswers reports: “A new law makes the purchase of products that combine annuities or insurance policies with long-term care insurance more attractive. These "hybrid" products are gaining in popularity due to a law that went into effect January 1, 2010, making distributions from life insurance and annuities tax-free when used to pay for long-term care. The same law also allows owners of annuities or life insurance policies to exchange their old policies for insurance for long-term care or hybrid policies without being taxed.” Combination sales which include life insurance, annuities and traditional long-term care coverage are becoming popular with insurance companies and may prove a method of financing long term care.  Investigate closely, however to find what exactly will be covered.  Some policies do not cover home care costs or complete costs of nursing homes. Long Term Care Insurance Funding for All Long Term Care Needs The first long-term care...

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Aging Parents, Alzheimer's/Dementia, At Home Care Solution, Health Care Reform, Lauren Reynolds, North County Home Care, San Diego Caregivers, San Diego Home Care / 21.12.2011

On December 15th, The Department of Labor announced a new proposed rule that could dramatically change how seniors and those with disabilities access home care.  The proposal would eliminate a long standing federal labor code exception that allows home care agencies and private families to avoid paying overtime and minimum wage to live-in caregivers.    (In California and many other states, minimum wage is already mandated by state law and paid, but the overtime exemption still exists.  Most reputable agencies in California already pay higher than minimum wage for hourly home care workers.) The overtime exemption dates back to 1974 and it was intended for domestic employees who “provide companionship services for individuals who (because of age or infirmity) are unable to care for themselves…” The idea was to allow a family or individual to hire a “caregiver” and set a wage for live-in, allowing the family to avoid excessive regulations regarding mandatory breaks, paperwork, etc.   Over the last three decades, the exemption has also been used by third party employers, such as home care agencies, to put caregivers in the home for so called “live-in” shifts.   The caregiver is typically paid for 16 hours of work per day and is given 8 hours of rest. The caregivers take meal breaks in the home and have access to restrooms, a phone, tv, and rest as needed.  However, regular labor codes, such as providing a 15 minute break every five hours of work, are not applicable. The Labor Department cited a large growth in the home care industry and a growing number of workers employed as caregivers as a reason to re-examine the live-in overtime exemption. Under the rules proposed December 15th, home care agencies and registries would no longer be able to use the exemption for live-in workers.   It’s not yet clear if that would mean live-in caregivers would have to be paid minimum wage the first 8 hours, time and a half the second four hours, then double time the next four hours.  If that is true, the cost to seniors and their families would go up by roughly 50 percent per day.   The result could be that families would turn to the underground economy for care and would perhaps hire unscrupulous individuals who are not vetted, trained, or supervised. Under the proposed new rules, Individuals and families could still use the exemption if they hired privately, however, that use would be narrowed.  For example, they could not hire a “professional” caregiver, or someone who provides care as a vocation.   They’d be able to use the exemption only if they hired a family member, friend, or someone who doesn’t ordinarily earn income from caregiving. The proposed rule clarifies that only incidental housework could be performed by the live-in caregiver.  Tasks such as cleaning dishes or doing a load of laundry would be okay.  Vacuuming would not be okay. Other incidental tasks to be allowed would include bathing, dressing, grooming, toileting, driving to appointments, feeding, etc. It’s also not clear what affect this would have on nannies or babysitters,...

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