Long Term Care Insurance covers caregiver training

A few weeks ago we got a frantic phone call in our office.

“Can you help me?” the caller asked. Always the optimist, I replied, “We’ll certainly try!”

The caller, a physician living in southern California, began by briefly telling me his story.

“My wife had a stroke not long ago,” he said. “I want to keep her at home and care for her, but I’m still working as a physician. I’ve got insurance to help pay for my wife’s care, but the caregivers I have hired need to be ‘certified.’ Can they get certified by you, through your online Caregiver’s Certification Course?”

I reassured the caller that we would be happy to talk with his insurance company to allow them to preview the course and discuss whether it met their qualifications. I explained to him that our company also provides online nursing assistant training, approved by the State of Oregon, as well as a variety of other approved courses. I gave him the link to see more course details, including sample course modules.

A week later, we got a call back from our physician friend. His insurance company had fully approved the online Caregiver Certification course as meeting their requirements, and he was ready to enroll the two private caregivers he had just hired.

Yesterday the phone rang again, just as I was getting ready to leave the office.

“My grandpa wants me to take the Caregiver’s Certification course,” said the caller.

She asked me a few questions about the course, specifically how an online course works and how she could finish her course, and then she shared with me her own story.

“I’m going to be caring for my grandpa, and he wants me to get trained. This online course fits into my schedule, since I can do it from my house or from my grandpa’s house.”

Smart grandpa! I know if one of my family members wanted to become my caregiver, I’d want them to have the training and skills to do it to the best of their ability.

Research shows that trained caregivers can continue to provide care up to 2 ½ years longer than caregivers without training and support. Not only is that worth the investment, but it is also worth the time and effort.

It’s an added benefit, too, if you can get the course covered by your insurance provider, or maybe even your employer.

If you want to explore these options for yourself, contact us. We’ll be happy to help you!

What do we do with Mom? Facing the needs of our aging parents

A friend cornered me at a social even last Saturday night.

“How do I get my parents to agree to move into assisted living?” he asked.

My first thought was, “Do you seriously expect me to answer that question on my way to get another glass of wine, at a party?!” but then, because I am so passionate about helping our parents the best way we can, I stopped to talk more about this.

It’s a question about 1 out of every 5 of my friends seem to be having these days.

What do we do with Mom?

How do we help Dad?

How do we make sure they’re OK, and maybe happy, too?

These are the questions we are all facing in our lives.

There are no “one-size-fits-all” answers out there. But there are some themes to guide us.

Quality of life. For me, this is the BIG ONE. I don’t really care where my parents choose to live. I don’t care whether they get help or not. I DO care if they are happy. If they are lonely, bored, depressed, or seem to have lost interest in life, they need a change. It won’t be enough for you to promise to visit more often – they need a bigger change than that.

Safety. This is the other BIG ONE. When my parents lived way out in the country – on the farm where they had lived forever, with their dogs, cows, goats, gardens, (wells and septic tanks, too), they were “happy.” But driving to the stores for simple groceries meant curving, country roads and at least 20-30 minutes. Driving to the doctors’ office, an increasingly more frequent outing, meant journeys of 45 minutes to an hour and a half, minimum, each way. The wood stove, the well, the garden, the hike from their house to the bottom of the hill to the barn – these things had lost their romance and now just looked like a great place to get injured. With driving being less of a good solution for either of them, how could they safely manage?

For both my parents and my in-laws, the solution was a senior living community. For my parents, it was a matter of safety. They chose a community, still out in the country, of cottages. It has a central “village” of services they can easily walk to, and a van if they need it for longer outings.

For my in-laws who already lived in town it was a matter of happiness. Socially outgoing people, they had lost nearly all of their life-long friends and companions. Staring at each other and watching golf on TV was getting old; the quality of life was quickly slipping away.

I won’t say it was easy in either case. It didn’t happen quickly. But we all agree today: it was a good thing. It was the right thing to do.

Stress of family caregiving adds challenge and opportunity

If you’re a family caregiver you won’t be surprised about the statistics related to stress and the caregiver.

It won’t shock you that the morbidity rate (illness) and the mortality rate (death) are both higher for caregivers than for non-caregivers.

You’ll probably nod at the most recent findings that caregivers experience higher stress in their marriages or personal relationships, too.

It’s a very stressful job, being a family caregiver.

Stress is our bodies’ way of handling the unknown or the feared. In nature it is a useful response to fright or a threat: the heart races, the adrenalin pumps and senses sharpen. The body is ready for fighting or fleeing – quickly. I’m sure you’ve noticed how quick it can happen if you see something in the middle of the road, for example, when you’re driving 60 miles an hour. In an instant you can feel the adrenalin surge through your entire body.

The problem with stress is that emotional situations cause our bodies to react in much the same way. Over time, the stress wears at us physically and emotionally. We may feel exhausted all the time. We may be irritable and jumpy.

In nature, stress is a powerful positive force. I believe that it can become a powerful, positive force for caregivers, too, if we can learn to recognize the early signs of stress – and then take action.

Perhaps your highest level of stress comes from not knowing what you’re going to find each time you walk into your parent’s home. Listening to your body, perhaps you realize that this is the moment when the adrenalin starts flooding, and you feel anxious and out-of-control. After all, you have no control over what you’re going to find, but you know whatever it is you’ll have to manage.

What could you do to reduce this stress point? Maybe you could call first on your way over, so you get some sense of what to expect. Maybe you could get another person – paid caregiver, neighbor, or family member – to drop by first and set the stage for your arrival to be less stressful.

Changing your caregiving relationship to one with less stress very likely will include some of these keys:

1) Get help. If you have felt the entire caregiving burden was on your shoulders, you need to stop – listen to your body – and take action. Set aside your personal sense of responsibility or your feelings that you should do it all, and get help. Ask your family, your church, your local senior center – get help. Knowing that it is NOT all on your shoulders may be the single most important thing you can do to reduce your personal stress.

2) Get support. Support may come from a different place than actual help with caregiving tasks. Support may come from your best friend, over a cup of coffee or a glass of wine. It may come from a formal or informal support group of other people, going through some of the same things you’re struggling with. It may come via an internet support group or email support team. It doesn’t really matter where it comes from – support is vital to reducing your stress and giving you the strength to continue as a caregiver.

3) Take time out. Your body’s stress is telling you to take a break. It’s telling you to step back and breathe deeply. You won’t be able to do this on your own. Most likely, you’ll need help. Respite – short term help – is available in many assisted living communities. Many in-home care agencies will provide short term help, too. Look for it wherever you can find it, and take a break.

Listen to your body. Learn to feel, hear and notice when your own stress level increases. Use this new awareness as an opportunity to take action to reduce your own caregiver stress. It’s a vital step to surviving – and thriving – as a caregiver.

Caregiver training essential to delivery of quality care

You need to hire a caregiver for a loved one. Perhaps you have a niece or nephew who needs a job, and who would love to help you. Maybe someone you know has recommended a good private caregiver they have used.

Hiring a private caregiver is a solution that many, many families use to assist in providing care to a loved one. Privately hired caregivers may be less expensive per hour than agency caregivers – and that makes sense when you realize that hiring an agency caregiver involves paying a portion of the wages of a supervisor and other support staff. For many families, the extra price is worthwhile because of the extra support they receive.

But for many families today, hiring a relative, neighbor, church friend or other private caregiver is simply the best solution to a challenging situation.

If this situation describes your current needs, here are some things to carefully consider:

1) Selecting a caregiver: Just because someone is available isn’t quite enough to qualify him as a good caregiver – although sometimes, out of desperation, that’s a major consideration. A good caregiver will have some personality traits that are more important than experience; traits like patience and caring, warmth and a sense of humor. The best caregivers are also creative problem-solvers – that skill allows them to provide care even when they don’t know exactly what they’re supposed to be doing or have never done the task before. How do you know whether the person you’re considering has these traits? The best way is to look at the person’s history. If you don’t personally know this individual, talk to 2-3 people who have known the person for at least a few years. Ask about these traits, and try to determine if this is a part of the individual’s personality. Here’s the key when interviewing candidates: Past behavior is the best determinant of future behavior. This is not, unfortunately, the job to see if your nephew’s rehabilitation for anger management was successful!

2) Caregiver Training. There are no national requirements for training of in-home caregivers. There are some basic parameters for home health aides and nursing assistants, and some states that have specific requirements, but in general, for caregivers, on-the-job training is often the only training they may receive. That’s not enough for you and your loved one. Demand at least a certificate level of training – it’s now easily available, and affordable, too, through a variety of classes as well as fully online through web-based training professionals.

Caregiver training is essential for in-home, privately hired caregivers. They have no support or supervisor to call when they run into questions about best care. Unlike a nursing assistant, there is no nurse down the hall they can contact for nursing or medical questions.

They may have no one to relieve them if the stress of caregiving becomes too great on a particular day, evening or night. That, and the fact that in-home private caregivers often spend hours alone with the person in their care, makes them vulnerable to stepping over the line from caregiving to abuse or neglect. This can be unintentional, as when the caregiver simply snaps and slaps at the hands of a person who won’t stop grabbing at him. It can be refusing to answer a call for help, if it’s been one of those nights and the caregiver simply can’t go assist one more time.

Any of these scenarios can happen, and happen without your awareness. Training – high quality, thorough skills building – can help prevent abuse and neglect while it builds stronger skills for coping with caregiving tasks and with caregiver stress.

Finally, consider training that provides the caregiver with an opportunity for career advancement, or with the ability to get their services covered by long-term care insurance policies. Courses that are provided by valid training organization, especially Certificate programs, will help you and your caregiver receive additional benefits beyond improved skills.

3) Stay in touch with the caregiver. Ask the private caregiver to keep track each day with notes about what he did that day, and what the person in his care required. You can use something as basic as a spiral notebook and a pen. Review his notes at least weekly, and talk to the caregiver about events he records. Give the caregiver your cell phone number and the number of at least one or two other people he can call in case of an emergency. Let the caregiver know that you understand that caregiving can be stressful, and give him permission to call you if he ever feels overwhelmed by the job.

Private in-home caregivers work today for many families all over the U.S. With some good planning, training and support, you can make it work for your family, too.

On living in a retirement community

For years I’ve been writing about my efforts to get my parents and my in-laws into senior housing. As a senior care professional, I know how important independence is to seniors but I also know how much faster people fail when their movement slows, social interaction is reduced and nutrition start getting overlooked for the sake of convenience. So for our parents, I wanted them to gain from the benefit of living with others in an active senior environment. I wanted them out of the driver's seat, too, if the truth be told.

We’re lucky in that both parents could afford this option. We live in a community with lots of housing choices, too. My mom chose a faith-based non-profit community of cottages; my in-laws a large for-profit high-rise closer into the city center.

The choice didn’t come easy. My in-laws, in particular, resisted the decision for a very long time. My mother-in-law was determined to die in the house she had lived in for the past 50+ years, just like her own mother did.

And then last Saturday night she fell. Right away my father-in-law pulled the emergency cord. Within minutes someone had come in to help calm them both and call 911. When the ambulance came the staff greeted them and make sure everything went well during the transfer to the hospital.

By the time we met them at the hospital, everything was fine. My father-in-law exclaimed over and over how glad he was that they lived where people could come to help immediately. "We have buttons or cords in almost every room!" he kept exclaiming.

My mother-in-law? Her main worry was whether she’d miss the special Sunday Brunch the next morning.

Is retirement housing or assisted living an option for you or your loved ones? Whatever your answer, focus on quality of life. Focus on what will increase your loved ones’ interaction with others, what will increase their physical activity and what will help ensure that they get good nutrition and, if needed, medication assistance. Think about how their move will affect you, too. Will it free you to focus more on your relationship and enjoy your time together, or will it cause you to spend even more time doing chores and handling responsibilities?

At the end of the day, it’s not where we live – it’s a matter of living a life rich with joy and meaning. It is, in a nutshell, about making it to Sunday Brunch!

Assisted Living companies in bankruptcy: what can a family do?

Every day I see a new article on another assisted living company entering financial difficulties. Some are filing for bankruptcy; many are on the brink.

If you have a loved one in an assisted living community, what should you do? Many families are feeling anxious about their loved ones' care as major companies like Sunwest Management Inc., one of the largest retirement housing providers in the country, files for bankruptcy protection in one state after another.

I know, from my own days as an owner and operator, when money is tight it's hard to focus on care. It's very hard to think about training and energizing employees who may not even be with you next month - or next week.

You spend hours every day looking for areas where you can cut expenses without hurting the people in your care.

As Eric Carlson, the director of long-term care for the National Senior Citizens Law Center said in a recent Denver Post article, "When facilities are losing money, they're tempted to cut staffing below safe levels."

If my own mom were in an assisted living or retirement community that was on the verge of bankruptcy, here's what I'd be looking for:

1) Basic life necessities: Food, water and heating. Stop in from time to time during a meal. Don't call ahead; just drop by. When communities are cutting beyond the point of reason you'll see meal portions reduced, dining rooms understaffed, and food served warm (when it's supposed to be cold) or cold (when it's supposed to be warm). Believe it or not, many companies in trouble delay paying utilities until the last notice, causing risk of basic water, sewer and power. I've heard more than one property manager talk about paying the utility bill out of her own pocket just hours before the shut-off was scheduled; I've never heard of a community getting all the way to shut-off, though. To me, that's a testament to the dedication of most community managers - they'll do everything in their power, literally, to keep the residents well cared for.

2) Talk casually to your loved on about call-lights, if they have them. Ask how long it takes someone to arrive. If the community is cutting too deep into staffing response times will lengthen dramatically. Let your loved one know who else to call if no one is coming to assist in a timely manner (for example, when is it appropriate to directly dial 911; when should they call you so you can ensure care?)

3) Sit in the lounge, living room or lobby and simply observe staff. If the company is managing their financial difficulties appropriately the staff providing direct care to residents - including housekeepers, maintenance staff and caregivers - will continue to be cheerful and talkative while they work. They won't show noticeable stress and anxiety about their own jobs. You should observe polite conversation (instead of stressed frustration and anger); hopefully even laughter and hugs when appropriate.

4) Pay attention to cleanliness and maintenance. Deep cuts can result in a building with a feeling of grime instead of polish; a lack of routine maintenance will result in light bulbs dark and toilets that run without stopping. In a busy assisted living or retirement community it doesn't take long for these things to become noticeable.

5) Finally, watch your loved one for signs of stress or anxiety. If he or she stays on top of the news a little anxiety will be normal; more than a little may mean that staff members are sharing their own stress with your loved one. Nothing causes a compassionate resident more despair than hearing, over and over, the trials of the people who provide them with daily services and caring attention.

If my own mom were living in a community in trouble, these are the things I'd watch for. And I'd know, seeing one of more of these conditions appear, that it was time to look for another home for my mom, before the company's difficulties became my own.

Alzheimer’s Caregivers can keep loved one out of nursing home for extra year and a half with simple training

Here’s the opening sentence to a new report that sheds exciting light on help for individuals caring for people with Alzheimer’s or memory loss:

The findings are stunning: Offering simple training to people struggling to care for loved ones with Alzheimer's disease not only eases their burden ---- it even can keep patients out of nursing homes for an extra 1.5 years. (Source)

The challenges in implementing what seems to be a simple solution to save families thousands of dollars in nursing home expenses is a common one for all caregivers: time and access.

For family caregivers, having enough time to attend training classes, let alone support groups, often means making complex arrangements to get someone else to stay with their loved one or find somewhere to leave the person with the memory loss.

Attending classes is challenging, too. Many are not available in rural areas; travel and expenses make traditional classes simply out of reach for many families.

But for family caregivers, technology offers exciting new solutions. The internet offers a wealth of resources and information on nearly every disease.

Internet based caregiver training can provide exactly what the caregiver needs to learn, when it’s needed. It can be accessed from the comfort of home, too, helping families avoid the need to travel to classes or fit them into a busy schedule, not to mention finding a caregiver for their loved one while they’re away.

Are behaviors a challenge? Find out how to prevent behaviors from happening, or how to appropriately respond when they do happen.

Is your loved one losing weight or having difficulty eating? Is showering a constant struggle? Going to the doctor mission: impossible?

One of the major benefits of taking online classes is that learning can be on-demand. That means that the caregiver can access the training they need at the time they need it. It eliminates the experience of attending a series of classes and then finding yourself, months from now, thinking, “I know they covered that in the class, but I can’t remember exactly what they said to do…”

Caregivers across the nation are finding the internet a tool to get support, too. Email or internet forums can become a tool for beginning conversations, getting custom tips and advice, and, in general, feeling less alone in the caregiving challenges.

Many websites offer information; many forums allow caregivers to share their experiences and support other caregivers.

Some, like Caring forMom, offers online training and support, all in one location.

For caregivers of people with memory loss and Alzheimer’s disease – for all caregivers, actually – technology today offers much more than peace of mind. It can offer real savings in terms of money that would be spent on facility care. It can also offer families the chance to do what they really want to do: keep their loved one at home and continue to provide the care needed.