News - At Home Nursing Care
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This past month At Home Care Solution teamed with Lorian Home Health Care, CVS pharmacy and other CAHSAH certified home care agencies in San Diego County to celebrate everyday heros in the home. As part of National Home Care month, parties were thrown across San Diego County at various CVS stores and 8 family and unpaid caregivers were awarded a combined $4000. [caption id="attachment_84" align="alignright" width="300"] Christy Stevenson gives a five minute makeover.[/caption]   At Home Care Solution helped to organize the party at the Encinitas CVS, where Christy Stevenson of Charisma by Christy donated her skills as a make up artist to give five minute make-overs. Diana Harvey of Healing Hands donated chair massages, which led to big smiles and relaxed shoulders. [caption id="attachment_81" align="alignleft" width="300"] Diana Harvey of Healing Hands provides a much needed back break.[/caption]   Denise Callas, Nursing Supervisor for At Home Care Solution, gave free blood pressure screenings. It was a fun afternoon that gave a much needed break to men and women who typically give care and rarely get care for themselves. The person recognized at the Encinitas party was Linda, a mother of four who is caring for her parents with chronic illness.  She was given a $500 prize and said, "Having just lost my car, everyday is a challenge, this money is so unexpected, thank you all." At Home Care Solution would like to thank CVS, Lorian Home Health, Christy Stevenson and Diana Harvey for donating their time and expertise to this worthwhile event. If you or someone you love needs home care in San Diego CA, remember to select a CAHSAH certified agency, such at At Home Care Solution.  CAHSAH certification means the agency screens and monitors its employees, has worker's compensation insurance, general liability and employee bonding, puts rates in writing and gets each employee screened for TB. For more information, visit CAHSAH online.    ...

“I found that when I didn’t have pain, I could forget I had cancer" - Cancer patient Chronic or excessive pain does not need to be part of aging, healing, or dying, a fact that Timothy Corbin, M.D. expressed to a crowd of nurses and social workers who gathered to learn more about alleviating pain. "Sometimes pain relief medications have scary names, which makes family members or patients want to avoid them," explained Dr. Corbin.  But the fear is needless, he commented. [caption id="attachment_68" align="alignright" width="300"] left to rt: Aviara's William Adams & Connie Garcia, Timothy Corbin, MD, Lauren Reynolds, At Home Care Solution & Aviara's Ana Morfin[/caption] Dr. Corbin is a hospitalist and palliative care consultant with Scripps Memorial Hospital, Encinitas, and he's also Regional Medical Director of The Elizabeth Hospice.  He spoke at a continuing education seminar for nurses, social workers, fiduciaries and nursing home administrators.  The seminar was held at Aviara Healthcare Center in Encinitas and was sponsored by Aviara and At Home Care Solution. Dr. Corbin explained that pain is the most common symptom of illness, and that unrelieved pain interferes with healing and diminishes quality of life. Sadly, he said that many dying patients continue to suffer from unrelieved pain during their last months  of life.  He also pointed out a 2007 Meta-Analysis which found pain present in 64% of patients with advanced cancer.  Additionally, he sited a JAMA study which said that 25% of long term care patients who complain of pain receive no treatment. The good news is that most pain during the terminal phase of life can be controlled relatively easily.  Dr. Corbin cited prescribing Morphine on a 24 hour schedule as one of the basic techniques of pain control in a palliative setting. One common concern about morphine at the end of life is a fear of addiction, which Dr. Corbin called an undue concern.  He pointed out that physical dependence is an expected result of long term use but should not be confused with addiction. He recommended increasing the dose of pain medications if they don't start working within a short period of time and said that the types of medications given should increase in strength if the first options do not provide relief. The nurses, social workers and fiduciaries in the audience appreciated learning about how to advocate for their patients and clients who are suffering with pain. At Home Care Solution is a California approved provider of continuing education. We would like to thank Aviara Healthcare Center, Dr. Corbin, and The Elizabeth Hospice of Escondido for providing this important information on elderly pain management as a service to our community. Contact us or read our blog to learn more about the importance of medication management for seniors. ...

More than 35 hundred participants turned out this past Saturday to help raise money for Alzheimer's research.  At Home Care Solution, one of only three local home care companies certified by the Alzheimer's Association for dementia care, was proud to be a Bronze corporate sponsor of the event. [caption id="attachment_63" align="alignright" width="300"] Lauren Reynolds with At Home Care Solution (left) with Betsy Evatt, Senior Care Management[/caption] The Walk to End Alzheimer's, held in Balboa Park, was a big success according to organizers with the San Diego/Imperial chapter of the Alzheimer's Association. Alzheimer's is now the sixth leading cause of death in the county and the third leading cause of death in San Diego. Roughly 53,000 San Diegans are living with Alzheimer's.  In California more than 588,000 people are believed to be living with Alzheimer's. At Home Care Solution founder and C.E.O. Lauren Reynolds joined Betsy Evatt, care manager with Senior Care Management to provide information about in-home care and health advocacy. At Home Care Solution provides quality hourly and live-in care for people with varying medical, social and psychological needs. Senior Care Management, run social workers with decades of experience in geriatric care, provides coordination of care including medical issues and appointments, safety assessments and referrals. For more information on Alzheimer's or the walk,  visit the Alzheimer's Association website. Find more info on Alzheimers and Dementia home care for San Diego county or Los Angeles counties on our website....

At Home Care Solution is proud to announce that we have been awarded Certification through the Alzheimer's Association. [caption id="attachment_55" align="alignright" width="300"] Laura Printy of the Alzheimer's Association and At Home Care Solution C.E.O. Lauren Reynolds[/caption] "Our mission is to provide the very best care from the most professional caregivers, and this certification demonstrates our continued commitment to that mission," said Lauren Reynolds, At Home Care Solution Founder & C.E.O. This designation is rare among home care companies in San Diego County.  Of the hundreds of companies which offer Alzheimers in home care, only 3, including At Home Care Solution, have earned certification from the Alzheimer’s Association. "We are very proud to be among the minority of agencies which take the time and devote the resources for this distinction," said Reynolds. Over the past several months, At Home Care Solution caregivers have completed 8 hours of specialized training in the area of dementia care at home.  Caregivers learned not only the health aspects of dementia and the various causes, but they also practiced effective communication techniques.  They've learned how to always practice patience and empathy while understanding the best ways to calm and encourage clients with memmory loss. If you or someone you love is living with memory loss, see how our advanced home care in San Diego or Los Angeles sets us apart. Call for a no-cost, in-home assessment at 760-634-8000.      ...

More Seniors Seek “Friends with Benefits.” Dr. Daniel Sewell, clinical professor and Medical Director at the Senior Behavioral Health at UCSD, first took an interest in researching sex in older adults when a nursing facility called him for advice. “A man and woman living at the nursing facility had fallen and love and began a physical relationship,” he explained, “and the woman had a husband living elsewhere.” The question about what to do sparked a research project and a lecture that now is in high demand. “I talk on a variety of topics, but when I’m requested as a speaker [the topic of age, sex and dementia] is what people request.” [caption id="attachment_46" align="alignright" width="300"] Lauren Reynolds - At Home Care Solution, Dr. Daniel Sewell - UCSD, Inan Linton & Shevonne Farrell - Belmont VillageThe UCSD professor spoke to two dozen elder care professionals including social workers, nurses, and case managers at a seminar sponsored by At Home Care Solution and Belmont Village in Cardiff.[/caption] “Sleep is important, appetite is important and sex is important.  Getting older or getting dementia doesn't necessarily change that,” Dr. Sewell pointed out. He said there are 5 primary drives of human behavior, thirst, hunger, pain avoidance, attachment, and libido or sex drive.    He said the last drive is one that is talked about the least when it comes to older adults. However, there are a couple of studies he cited.  He had to chuckle when telling the crowd that one study considered older to be age 50 and upward.   It found that 20 to 30 percent of men and women are sexually active into their 80’s. The biggest determinants of whether an “older” person will be sexually active is their relationship status and health. “If you have a partner, you’re more likely to have sex, and if you are healthy, you’re more likely to have sex,” he said. A newer phenomenon, he explained, was the fact that one out of 5 men is having sexual contact with a “friend” or “new acquaintance”, the “friends with benefits” as it’s called in media. The percentage of women doing the same is less, but still significant, at 13.5%.  He suspected that this more casual approach to sex has to do with the fact that older adults don’t want to complicate their lives with second or third marriages, so they’re open to the idea of sex with a less rigid relationship structure. The drawback is that this behavior puts older adults at risk for sexually transmitted diseases if they don’t practice safe sex.  Older adults may think that because birth control is not needed, protection is also not needed. Another interesting fact is that 14% of men report using some kind of supplement to improve their sex life. A 2007 study also found that adults age 57 to 64 had a 73 % prevalence of sexual activity, for those 65 to 74 it’s 53%, and 75 to 85-year-olds had a 26% prevalence of sexual activity. Dr. Sewell pointed out that older adults are rarely asked about sexual issues by their doctors or case...

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....

The idea of planning is to stay one step ahead of split-second decisions and crisis troubles, but still a large percentage of families are reluctant to tackle an estate plan.   This week a group of financial planners, retirement planners and fiduciaries sat down to discuss the most common reasons families avoid dealing with estate plans. For this purpose, an estate plan is essentially a will and a trust, long term care insurance if needed, a power of attorney, power of health care directive and a Polst or DNR form. Denial came up as #1 to avoid estate planning.   Few younger people want to face the idea that they could be here one day, gone tomorrow, whether due to accident or illness.  Older individuals tend to be better prepared, but that doesn't mean they're willing to talk about their end of life wishes, such as how much medical intervention they desire and when to access in-home care or assisted living options. Often families think they don't have enough assets for an estate plan, for example, those who are upside down in their mortgages right now. The #3 reason to avoid an estate plan is procrastination.  It's this idea that we know we need an estate plan, and we're going to get to it as soon as we can.  Problem is, this lack of a firm timeline makes it possible to just continually kick the can down the road. Many people don't know how to start an estate plan, so they simply don't start one.  A good place to start is with a financial planner or trust attorney.  There are also online resources that can help with basic preparations.   Even a simple hand written will is better than none at all. The #5 reason to avoid a trust is conflict.  Many families end up arguing when financial or end of life issues are brought up.  One case study involving this was an elderly couple who had fought over money their entire 60 year marriage.  They never did agree on how to gift it upon death.  When both spouses died within four months of each other, with no children, their substantial estate ended up in probate court. Given the current economic realities, many people right now are just in "survival" mode, not planning mode.  If someone is concerned about havign enough money to buy food, pay rent or the mortgage or pay high college tuition or student loans, they are less likely to be planning adequately for retirmement. The #7 reason is that they just don't understand the need.  Many people think that their assets will simply pass to the heirs of their choosing without considering squabbles, tax implications, the cost of probate court and any number of problems they can't forsee. Especially for those experiencing loss or health issues, depression may be a reason to avoid an estate plan.  That came up as reason #8.  When someone is experiencing emotional pain, it's hard to care about what may happen that day, let alone at some random point down the...

Informal caregivers are family, friends or volunteers who provide care for a loved one. Informal caregivers are rarely paid directly for their services. They may receive indirect payment through sharing a loved one's income or assets. Although informal caregivers may provide services in a facility, in most cases they are providers of care in the home. Caregivers face many challenges providing care at home. A wife caring for her husband may risk injury trying to move him or help him bathe or use the toilet. The financial impact is another challenge. The financial burden depends on who the informal caregiver is. For a spouse there is typically no financial cost since income and assets will be the same with or without a need for care. However, if a spouse offering informal care is employed and has to quit his or her job to provide care there is a significant impact on that family's finances. Despite the fact that there may be no significant financial impact on a spouse caring for the other spouse at home, there can be significant impact on the emotional and physical health of the caregiving spouse. Because of the strain and burnout often associated with caregiving, the healthy spouse may experience deteriorating health and eventually require long term care services as well. In some cases healthy spouses have succumbed drastically to the pressures of caregiving and died prematurely, well before their care recipients have died. Another caregiver challenge may be the need of constant surveillance on a spouse with advanced dementia.  Still another caregiving challenge could be a son living 500 miles from his disabled parents and constantly traveling to and from his home, trying to manage a job and his own family as well as taking care of the parents.  Other challenges to home care may be caregivers who simply don't have the time to watch over loved ones and those loved ones are sometimes neglected. The problems with maintaining home care are mainly due to the inadequacies or lack of resources with informal caregivers, but they may also be caused by incompetent formal caregivers. These problems center on five issues: Inadequate care provided to a loved one Lack of training for caregivers Lack of social stimulation for care recipients Informal caregivers unable to handle the challenge Depression and physical ailments caused by caregiver burnout In order to make sure home care is a feasible option and can be sustained for a period of time, caregivers must understand the problems outlined above, deal with them and correct them. This often involves bringing in so-called formal caregiver assistance such as care managers, home care companies or other long term care advisors. The responsibility for recognizing home care challenges and solving them is shouldered by the team of specialists and advisors that have been invited in to offer their help.  ...

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. ...