Caring for Elders

At Home Care Solution is proud to announce that one of our most compassionate and professional caregivers is the recipient of our Above and Beyond Award. [caption id="attachment_39" align="alignright" width="300" caption="Above and Beyond Award Recipient"][/caption] Dianne learned to be an excellent caregiver through her own life experiences.  She first cared for her father-in-law who had Alzheimer's disease and then provided around the clock care for another relative who was diagnosed with cancer. Dedicated to always learn and grow, Dianne earned high marks in our proprietary training program and said it confirmed that she was using both common sense and compassion to address the toughest challenges of caring for those affected by Alzheimer's or dementia. Clients of Dianne praise her punctuality, responsibility, attention to detail and desire to go way above and beyond their expectations.  When Dianne noticed a client adding notes in the margins of a daily health chart, Dianne took the initiative to go home and redesign the chart.  She worked on her computer for hours to create the perfect template.  Her client was so pleased to have a simpler way to measure daily health readings. Dianne's clients have been both men and women, and she thoroughly enjoys improving the quality of their days with her.  Dianne is one of the reasons that At Home Care Solution is one of the fastest growing providers of quality home care services across San Diego County.      ...

Those arrested include 10 doctors, nurses, and Medicare recipients In a coordinated effort that was the largest single Medicare Fraud strike force take-down to date, 91 people were arrested this week for a Medicare fraud scheme totaling $295 million dollars. The services involved included durable medical equipment, physical and occupational therapy, mental health services, psychotherapy, HIV infusion and home health care. The coordinated action took place in eight cities, including Miami, Houston, Baton Rouge, Los Angeles, Detroit, Chicago, Dallas and Brooklyn. Those arrested include nurses, physicians, other medication professionals and various providers. They face charges of conspiracy to defraud Medicare, health care fraud, violations of the anti-kickback law and money laundering. The arrests drew praise from the National Association for Home Care & Hospice, of which At Home Care Solution is a member. “We agree that our policy must be zero tolerance for those who would steal from the public purse and thus undermine the care being provided to aged and inform, disabled and dying Americans,” NAHC President Val J. Halamandaris said in a written release. According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were never provided or for treatments that were not medically necessary.  Documents show that patient recruiters, Medicare beneficiaries and others were paid cash kickbacks in return for supplying information that could be used to submit the false claims. “The health care system is part of our nation’s infrastructure and we must do everything in our power to protect the integrity of Medicare and the system at large,” said FBI Executive Assistant Director Henry. “Working together as partners, we can stop criminals who seek to steal American taxpayers’ hard-earned dollars and we help ensure our nation’s health care system is there for those who need it.” Since it’s start in 2007, the Medicare Fraud Strike Force, a joint-operation among government agencies and law enforcement, has uncovered nearly $3 billion in Medicare Fraud. To read more about the investigation and arrests, visit the US Health and Human Services website. Contact At Home Nursing Care for more information on hospice care in San Diego or Los Angeles....

Walk into the average senior citizen’s home and you’ll likely find a pill box filled with multiple pills of varying sizes and colors.   Seniors consume 40% of all prescription drugs manufactured in the United States, and they also purchase 35 % of the over the counter medications. The reasons for this vary, from over-medication to control of chronic diseases and multiple conditions.  The result is often confusion.  The average 65 to 69 year old takes 14 prescriptions per year, while those individuals aged 80 to 84 consumer 18 prescriptions per hear. Not all of those pills are medically necessary.  According to the Journal of the American Geriatric Society, about 15 to 25 percent of medication use in seniors is unnecessary or inappropriate.   Of that number, the medications over prescribed most often are antihistamines, laxatives, antispasmodics and anti-depressants.    These medications can cause side-effects that might simply look like symptoms of a disease like dementia, including blurred vision, incontinence and falls. Many times seniors get medications from various doctors, or have prescriptions filled at various pharmacies.  As a result, the medications they think they’re taking to get better make them worse.  In fact, adverse drug reactions are responsible for 28% of hospitalizations among older adults.  And 36% of all reported adverse drug reactions involve an elderly individual. Beers conducted a study that looked at the number of medications that needed to be taken before the risk of an adverse interaction occurred.  Turns out it’s not a large number.  When someone takes more than four medications, their risk for an interaction goes up 100 percent. Learning medication management tips, and managing medications is critical to reducing the risks of adverse reaction.   What medication management really involves is making sure the medications being taken are medically necessary.  Secondly, medication management involves making sure those that are needed are taken properly. Some ways in which people don’t adhere to a medication schedule include failing to fill a prescription or a refill, skipping does, taking more than prescribed, taking medications at the wrong time, with the wrong food or liquids, taking expired or damaged medications or not using medical devices properly. Cost can be a factor, too.  When a family is paying $300 a month for a medication like Aricept, used to treat symptoms of Alzheimer’s, there is sometimes a financial incentive to take fewer of the pills.  However, Aricept is a medication that needs to be tapered off. When a loved one has dementia, medication management can be extremely difficult.  Family members and caregivers need to be involved, or if out of town, the use of a nurse care manager may be the best alternative.   As for home care medication management, under California law, home care aides are not allowed to administer medications or organize pill boxes. An RN or LVN is allowed to organize pill boxes, as long as they are employed by a licensed home health agency.  Most home care agencies do not have this license, so be wary if they offer to organize pill boxes for your loved one. ...

When we are young, falling is a fact of life, a normal rite of passage.   It’s something that happens the moment we start toddling and continues through the new bike years of childhood.  By the teenage years, our falls are pretty much limited to the “head over heals” kind or those caused by sports.  As young people, we only think of really violent falls as serious, the ones where our heads hit concrete or when we fall off something from a high distance. The young boy with the broken arm loves the attention he gets from his classmates for a fall that caused damage that is temporary.  It will likely heal in six weeks. Seniors, on the other hand, want no attention for falling.  Many fear the consequences not just to their bodies, but to their way of life.   A fall might mean a loss of independence, a sign of growing physical weakness, an “excuse” for the “kids” to start talking about nursing homes. It’s true, falls are far more devastating, on average, for older people.  Falls are the number 1 reason for admission to skilled nursing facilities and they are a major factor in 40 % of all admissions for any reason.   1 in 3 seniors fall each year. In San Diego County, in 2008, there were 12, 535 seniors treated in the emergency department for falls.  In 2007, falls were the cause of 186 deaths. Why so many falls?  First, let’s look at how our balance system works.  We have our sense of vision, or sence of touch, and our vestibular/inner ear.   Our eyesight and our inner ear help keep us stable.  Information from our eyesight, inner ear, and our sense of touch is coordinated in our brain to give us balance.    The problem is, as we age, our vision and our ability to sense the ground through our shoes are diminished.   Also, changes in our strength and flexibility affect our ability to quickly “right ourselves” if we start to fall. Factors that may hinder our balance and make us more likely to fall include medical issues, physical issues, and cognitive issues. From a medical standpoint, here are some common reasons a person’s balance is compromised.  Arthritis can make it difficult or painful to move around.   High or low blood pressure may lead to dizziness.   Diabetes can lead to nerve damage and numbness in the feet.  Osteoporosis, or brittle bones, makes injury from a fall more likely.  Parkinson’s causes a person to have diminishing control over their movements.  Stroke or brain injuries affect balance.  Even incontinence can cause falls, because the senior may rush to get to a restroom and move too quickly. Medications are another big issue, with side-effects and interactions.  Blood thinners like Coumadin make even the slightest of falls very serious.  Sedatives, pain meds and antidepressants can also lead to falls.  One way to deal with this issue is to talk to your doctor or pharmacist, keep an updated list of all your medications and post a Vial of Life on the fridge. Some physical causes of falls include generalized weakness, a simple loss of muscle over time.  This...

Jewelry theft and financial abuse are most common problems Deputy District Attorney Greenwood, head of the elder abuse prosecution unit in San Diego County, has never been busier.  He credits the testimony on March 2nd of 90 year old actor Mickey Rooney. “Within two days of Mickey Rooney testifying before Congress on March 2nd, my phone was ringing,” Greenwood said to a crowd of investigators, attorneys, and elder care professionals attending an educational seminar at Somerford Place Alzheimer’s Assisted Living.  The seminar was sponsored by Somerford Place and At Home Care Solutions, owned by RSF resident Lauren Reynolds. Rooney’s testimony about being deprived of food and medicine, allegedly by his step-children, brought elder abuse into the national spotlight, Greenwood said, illustrating that it’s a growing national problem. “You are going to see many more people who are potential victims,” Greenwood explained, based on demographics.  In San Diego County, about 16 % of the population is over 65, roughly half a million people. “The problem is that people are being looted in San Diego County every day,” he said. He explained that jewelry is the number one item being stolen from seniors in San Diego.  One recent case involved a housecleaner/caregiver in Poway.  When a homeowner reported the jewelry missing, sheriff deputies installed a video camera in the bedroom and actually caught the housekeeper on tape taking items from a drawer. “Turned out that housekeeper worked for 12 other people,” Greenwood said, “and 9 of the 12 had jewelry missing.” His advice is that seniors keep an inventory of jewelry including pictures.  Valuables should be kept in a locked drawer or safe.   And he said there is a pattern for whom is doing the stealing. “The #1 culprit is a convicted felon turned caregiver,” he explained. There is no law requiring background checks on caregivers and some unscrupulous agencies hire them based only on “self-reporting” of any past criminal history. (At Home Care Solution, a fully certified home care agency, runs local, state and federal background checks on all of their employees.) Secondly, Greenwood said, adult sons who are lazy, unemployed and addicted to drugs or alcohol tend to be the thieves, followed by tradesmen who are in the home to provide a service. “In one case, a carpet cleaner used his high powered hose to actually vacuum the jewelry out of the drawer and into his van,” Greenwood said. The criminals prey on confusion and fear.  One local man called up an elderly woman, claimed to be her grandson and convinced her that he needed $100,000 to be wired to China.  The fake grandson told the woman he desperately needed the money for a legal settlement.  Greenwood blamed the bank for allowing the suspect transaction to go through. There is an Adult Protective Services hotline to call for those who suspect elder abuse, 1-800-510-2020.  However, Greenwood admitted the strapped state budget has left the hotline understaffed and the wait can be up to an hour. He hopes the state legislature will soon pass a pending bill that would allow reports of elder abuse...