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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,...

There is no question health care spending is a critical issue.   Approximately 17 % of our gross domestic product is related to expenditures in health care, an amount that's seen a steady rise.Health care reform was proposed as a solution to the rising costs, but Steve Espinoza of the Hospital Association of San Diego and Imperial County warns the road ahead is clouded with fog and haze.Take Accountable Care Organizations for example.  Espinoza explains them this way, "It's like a unicorn, everyone knows what it is, but no one has ever seen one."What is Health Care Reform? The Health care reform is a 10 year process, with a watershed year being 2014, assuming the constitutional challenges are met and an individual mandate to buy insurance or face a penalty survives.Accountable Care Organizations are one part of the plan.  Put simply, ACO's are a way to reduce costs, by reducing unnecessary tests or procedures.  Those in the organization would share the cost savings and the potential risks of getting less reimbursement for undesirable outcomes.  Another major goal is to reduce hospital readmission rates within a 30 day period for the same diagnosis.Espinoza likens the idea to a TV Manufacturer, say Sony for example.  Sony uses lots of different vendors for the parts...

Caregivers often don’t recognize when they are in over their heads until they reach a breaking point.  Short-term the caregiver can handle it. Long-term, help is often needed.A typical pattern with an overloaded caregiver may unfold as follows:1 to 18 months - the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support. 20 to 36 months - the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless. 38 to 50 months - Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well.At Home Care Solution provides nurse case management, social worker case management, and high quality certified nursing assistants, home health aides and caregivers to assist when families become overwhelmed.  We provide care on an hourly basis and we specialize in high quality and affordable live-in care for 24 hour peace of mind.With the holiday season upon us, caregivers feel even more stress -- with planning, shopping and participating in holiday activities. This is a perfect time for family and friends to step up and provide some respite time and caregiving help.  Whether it is provided personally or arranged as a gift of services to be provided by a professional respite company or home care provider, it is a welcome gift.An article in “Today’s Caregiver” states: “Nearly one in four caregivers of people with Alzheimer’s disease and other dementias provide 40 hours a week or more of care. Seventy-one percent sustain this commitment for more than a year, and 32 percent do so for five years or more. One of the best gifts you can give someone caring for Alzheimer’s is something that provides a bit of respite and relieves the caregivers stress. The Gift of time: Cost-effective and truly meaningful gifts are self-made coupons for cleaning the house, preparing a meal, moving lawn/shoveling driveway, respite times that allow the caregiver time off to focus on what he/she needs.” It is also important to note that hiring professional care provider services can provide valuable ongoing support to an overloaded caregiver. A financial planner, care funding specialist or a reverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long term care issues. The care manager has been there many times -- the family is experiencing it for the first time.An elder law...

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 patientChronic 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 recipientsIn 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....