OurParents

Nursing Homes: What Is “Person-Centered Care”?

Leigh Ann Otte — Fri, 24 May 2013 11:00:55 +0000

Have you heard of the “person-centered care” philosophy some nursing homes are embracing? It’s changing the way these facilities are run. But what does it actually involve?

Basically, incorporating person-centered care means creating “a personalized environment that is targeted toward an individual’s likes, preferences and needs,” explains J. Emmett Reed, the executive director of the Florida Health Care Association. In an editorial at TheLedger.com, the website for a Lakeland, FL, newspaper, Reed writes:

The purpose [of person-centered care] is to help improve residents’ quality of life with more choices and more involvement in the day-to-day planning of their activities. Residents have more choices in meal selections and other activities of daily living.

Additionally, the front-line workers who provide the bulk of the care are being given greater autonomy with their assigned residents to encourage staffing consistencies and strong friendships with residents.

We’ve written about this and other care philosophies previously, including in these posts:

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Leigh Ann Otte is a freelance writer who specializes in health and aging issues. She covers finding and paying for senior care for OurParents. If you have any questions about this post or need help finding senior-care options for a loved one, call 1-866-483-4896 to speak with a care advisor in your area.

Report: Assisted Living Industry “Weary” of Discounts

Leigh Ann Otte — Thu, 23 May 2013 11:00:49 +0000

For a while now, assisted living communities have been offering deals to entice people to move in. But an article in The Charlotte Observer suggests that trend may be poised to fade out soon.

Reporting on the Assisted Living Federation of America’s recent conference in Charlotte, NC, the Observer notes that the price is high for assisted living—an average of $3,022 per month for a one-bedroom apartment, not including certain care fees. But pressure to keep units rented is also high.

That’s why communities in recent years have offered price cuts, such as one-month free rent – to help seal the deal and keep apartments full.

The industry is growing weary of price breaks as the economy recovers. But savvy consumers are still asking for deals, and sales counselors are unprepared with how to deal otherwise, said Bild. “One of the repercussions we’re living with … is the record rate of discounting during the Great Recession.”

So for now, it seems the deals are still present, though you may need to ask for them.

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Good Assisted Living Activities Can Be As Simple As Gardening

Leigh Ann Otte — Wed, 22 May 2013 11:00:10 +0000

Finding a good assisted living community is about more than finding a nice place to live. For one thing, the community should offer fulfilling activities that keep your loved one engaged—preferably, activities that fit your loved one’s unique personality and experiences.

At The Huffington Post, Marguerite Manteau-Rao, a social worker who specializes in dementia care, shares an example. In an article about how to help a parent transition to assisted living, she suggests:

Brainstorm with the staff and together devise a plan for maintaining your loved one’s sense of self and self-esteem. This is best accomplished by figuring out what important part of the person’s identity can be activated in the new environment. Was the person a gardener? Maybe she can be encouraged to help with the community garden.

As Manteau-Rao’s tip demonstrates, the activity need not be extravagant. It just needs to be fulfilling.

Manteau-Rao’s other tips for helping someone transition to assisted living include making sure the staff understand the person’s personal preferences and past routines.

For tips on what to look for in assisted living communities, click here.

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What Happens When Veteran Dies Before Special Pension Is Approved

Leigh Ann Otte — Tue, 21 May 2013 11:00:35 +0000

Just because the VA says you’re out of luck doesn’t mean you really are.

The Aid and Attendance pension helps many veterans pay for long-term care. But the application process for this benefit is long and frustrating. The New Old Age talks about this in a recent post and points out that many veterans die before their application is approved. However, that doesn’t mean the family can’t get any money—even if the VA makes it sound like they can’t. From the post:

If a veteran or spouse dies before receiving the benefit, the family gets a condolence letter saying, “Your case is now closed.” That letter may arrive within days of the death.

Even though most veterans and their families take the V.A. at its word and give up, the case is not necessarily “closed.” If relatives can prove that the application would have been approved, they qualify to be reimbursed for any expenses for care since the time of applying for the benefit. (The form can be found here: Application for Accrued Amounts Due a Deceased Beneficiary.)

If you’re applying for Aid and Attandance—or interested in it—these OurParents articles may also be helpful:

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Elderly Parents Refuse Help? Ask This Simple Question.

Leigh Ann Otte — Mon, 20 May 2013 11:00:09 +0000

It can be frustrating when an elderly parent needs help at home but refuses it. What to do?

Take a breath, and find the answer to a simple question: Why? That’s what Judy Santamaria, director of family caregiver support at Visiting Nurse Service of New York, says in an article at The Huffington Post:

Try to understand the reasons for your loved one’s resistance. Is it a fear of dependence, loss of dignity or financial worries? Try to talk with them about these feelings, so they know you are hearing them. And give your family member as many choices as possible. The worst thing you can do is come in like gang-busters and take away all control; this will only increase their fears and thus their resistance.

If your parent does end up accepting help, Santamaria recommends starting out slowly, with just a little in-home care a week.

If you’re dealing with someone who refuses help, these previous OurParents posts may also be helpful:

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Charity Helps Fulfill Dying Adults’ Dreams

Leigh Ann Otte — Fri, 17 May 2013 11:00:50 +0000

Linda Omundson, of Lakeland, FL, dreamed of going on a hot-air balloon ride with her daughter. But the 63-year-old didn’t have a lot of time left to fulfill it. She was dying of cancer.

So a resource associate with her hospice agency contacted Dream Foundation in Santa Barbara, CA, reports Florida newspaper The Ledger. And Omundson got her wish. On April 16, she and her daughter soared over the Florida trees.

Many wish-granting charities focus on children, but there are some that help adults too. About Dream Foundation in particular, The Ledger says:

The group helps adults who have life-limiting illnesses and are diagnosed as having less than a year to live.

Patients’ dreams range from basic needs, like a comfortable chair, to family vacations with children. The group relies on donations, according to its Web site, www.dreamfoundation.org.

You may also be interested in these related OurParents posts:

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Government Senior-Care Program Provides Outside-the-Box Solution

Leigh Ann Otte — Thu, 16 May 2013 11:00:52 +0000

When’s the last time you heard of Medicaid buying someone an air-conditioner?

That’s what a PACE program did in Council Bluffs, IA, the Omaha World Herald reports.

PACE, the Program of All-Inclusive Care for the Elderly, is available in some states to help keep people who need care out of nursing homes. The newspaper explains:

People eligible for Medicaid only or both Medicare and Medicaid pay no monthly premiums and get all program services, including prescription drugs. Those who don’t qualify for Medicaid also can enroll but are charged a monthly premium.

Participants go to one facility to socialize and meet with a variety of health care providers.

Program providers receive a flat fee per person, according to the article—no matter the care costs. Steve Hess, a vice president of the organization that runs the Council Bluffs location, sees that as an incentive to keep participants as healthy as possible. And that leads us to the air-conditioner. The Herald reports:

Hess noted that last July, the air conditioner in the Council Bluffs home of one program participant broke down. The heat worsened her chronic breathing problems, he said, so the next day, center officials paid $400 to buy a new air conditioner and install it in the woman’s apartment.

“For $400, we avoided a potential emergency room visit” that would have cost $5,000, Hess said. Traditional health insurance wouldn’t have covered the cost of the air conditioner, he said.

You can learn more about the PACE program here.

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Senior-Focused Technology Connects Assisted Living Residents to Family

Leigh Ann Otte — Wed, 15 May 2013 11:00:36 +0000

These days, family members are living all over the country—sometimes the world. That leaves many seniors in assisted living separated from their loved ones. So some communities are helping them connect through specialized technology.

The Florida news site HeraldTribune.com reports on one such community, Bahia Oaks Lodge. There and at many other such Brookdale Senior Living properties, residents access a system called ConnectedLiving through campus computers or on their personal devices “and get rapid access to emails, photos and texts from families and friends.”

They can get human assistance printing out these messages, or arranging family video chats. When ConnectedLiving is installed in a facility, all residents are given passwords and invited to sign up the important people in their lives. If they are reluctant to brave the keyboard and mouse, they can use the touchscreen. …

ConnectedLiving’s [CEO Sarah] Hoit says her field is dominated by companies “who tried to put technology in front of the demographic,” without considering the unique interests and learning patterns of older people. This led to investments in gadgets they didn’t want, she says, “and after about a month of novelty, they weren’t used.”

Technology is changing lifestyles in senior living communities across the country. Here are some related posts we’ve written:

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Not All Dementia Units Trump Regular Units, Studies Find

Leigh Ann Otte — Tue, 14 May 2013 11:00:14 +0000

Conventional wisdom says that in a nursing home, a memory care unit is better for people with dementia. These specialized wings supposedly cater to these folks’ needs. But do they really provide a better quality of life?

Perhaps not always, according to senior-care writer Paula Span. She found varied results in studies. She reports at the blog The New Old Age:

“There are mixed signals” about dementia units, [Andrea Gruneir, a health scientist at Women’s College Research Institute in Toronto] acknowledged. “Sometimes it looks like they do better on some things, and other times they don’t seem to make much difference.”

That’s probably because there’s little standardization or regulation of what dementia units should offer and for whom, so some probably do a fine job while others just lock the doors. . …

But the clear bottom line is that families looking for nursing homes for loved ones with dementia still have to undertake due diligence: visiting at various times of day, asking questions, looking at medicare.gov ratings, talking to other residents’ families.

You can check out reviews of dementia care units you’re considering here. For more tips on how to choose nursing-home-based dementia care, check out these previous OurParents posts:

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Largest for-Profit Hospice Provider Accused of Fraud

Leigh Ann Otte — Mon, 13 May 2013 11:00:37 +0000

The U.S. is suing the nation’s biggest for-profit hospice provider. In a lawsuit filed earlier this month, the government accuses Vitas Hospice Services of Medicare fraud that began in 2001, ABC News reports.

Two types of fraud are alleged: accepting ineligible patients for hospice care and billing Medicare for “crisis care” that never happened or wasn’t needed. (Crisis care is billed at a higher rate.) From ABC News:

The crux of the government’s charge is “that Vitas focused on maximizing Medicare reimbursements for as many patents (sic) as possible while disregarding patients’ medical needs and Medicare guidelines. Vitas regularly ignored concerns expressed by its own physicians and nurses regarding whether its hospice patients were receiving appropriate care.”

In a statement, the company says it will fight the charges and that it has worked to “uphold the highest industry standards.”

This story may remind you of our January post, “Medicare Cracking Down on Hospices With Long-Term Patients.”

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