Long-Term Care: Home-Based Services

Services from Unpaid
Home-based long-term care includes health, personal, and
support services to help people stay at home and live as independently as
possible. Most long-term care is provided either in the home of the person
receiving services or at a family member’s home. In-home services may be
short-term for someone who is recovering from an operation for example or
long-term for people who need ongoing help.
Most home-based services involve personal care such as help
with bathing, dressing, and taking medications, and supervision to make sure a
person is safe. Unpaid family members, partners, friends, and neighbors provide
most of this type of care.

Services from Paid
Home-based long-term care services can also be provided by
paid caregivers including caregivers found informally, and health care
professionals such as nurses, home health care aides, therapists, and
homemakers, who are hired through home health care agencies. These services
  •          Home health care
  •          Homemaker services
  •          Friendly visitor/companion services
  •          Emergency response systems

Home Health Care
Home health care involves part-time medical services ordered
by a physician for a specific condition. These services may include nursing
care to help a person recover from surgery, an accident, or illness. Home
health care may also include physical, occupational, or speech therapy and temporary
home health aide services. These services are provided by home health care
agencies approved by Medicare.

Friendly Visitor/Companion
Friendly visitor/companion services are usually staffed by
volunteers who regularly pay visits to someone who is frail or living
alone. You can also purchase these services from home health agencies like us. Give us a call at 727-443-2273 for a free consultation if you or someone you know needs companion services. You can also visit our website at www.advsrs.com.

Emergency Response
Emergency response systems automatically respond to medical
and other emergencies via electronic monitors. The user wears a necklace or
bracelet with a button to push in an emergency.  Pushing the button summons emergency help to
the home. This type of service is especially useful for people who live alone
or are a risk of falling. A monthly fee is charged. Safety Watch, our sister company offers this service. Call us at 727-443-2273 for more info.
See Part 2 to this article, Long-term care: Community based Services in the next article on Wednesday,
Source: nihseniorhealth.gov/longtermcare/homebasedservices/01.html

Long-Term Care

What is Long-Term
Long-term care involves a variety of services designed to
meet a person’s health or personal care needs during a short or long period of
time. These services help people live as independently and safely as possible
when they can no longer perform everyday activities on their own.

Most Care Provided at Home
care is provided in different places by different caregivers, depending on a
person’s needs. Most long-term care is provided at home by unpaid family
members and friends. Care can also be provided by paid caregivers, usually at
home, but also in a facility such as a nursing home.
The most common type of long-term
care is personal care, which is help with everyday activities, also called “activities
of daily living.” These activities include bathing, dressing, grooming, using
the toilet, eating, and moving around. For example, getting the person out of bed
and into a chair.
Long-term care also includes community services such as
meals, adult day care, and transportation services. These services may be
provided free or for a fee.

Health Drives the Need for Care
People often
need long-term care when they have a serious, ongoing health condition or
disability. The need for long-term care can arise suddenly, such as after a
heart attack or stroke. Most often, however, it develops gradually, as people
get older and frailer or as an illness or disability gets worse.
How Long Does Care Last?
care can last a short time or a long time. Short-term care lasts several weeks
or a few months while someone is recovering from a sudden illness or injury.
For example, a person may get short-term rehabilitation therapy at a nursing
facility after hip surgery, then go home.
care can be ongoing, as with someone who is severely disabled from a stroke or
who has Alzheimer’s disease. Many people can remain at home if they have help
from family and friends or paid services. But some people move permanently to a
nursing home or other type of facility if their needs can no longer be met at
About 70% of
people over age 65 need some type of long-term care during their lifetime. More
than 40% need care in a nursing home for some period of time.
Who Will Need Long-Term Care?
It is difficult to predict how much or what type of
long-term care a person might need. Several things increase the risk of needing
long-term care.
  •          Age-The risk generally increases as people get
  •          Gender-Women are at higher risk than men,
    primarily because they often live longer.
  •          Marital status-Single people are more likely
    than married people to need care from a paid provider.
  •          Lifestyle-Poor diet and exercise habits can
    increase a person’s risk.
  •          Health and family history-These factors also
    affect risk.


Hearing Loss

What is Hearing Loss?
Hearing loss is a common problem caused by noise, aging,
disease, and heredity. Hearing is a complex sense involving both the ear’s
ability to detect sounds and the brain’s ability to interpret those sounds,
including the sounds of speech. Factors that determine how much hearing loss
will negatively affect a person’s quality of life include:
  •          The degree of the hearing loss.
  •          The pattern of hearing loss across different
    frequencies (pitches).
  •          Whether one or both ears are affected.
  •          The areas of the auditory system that are not working
    normally, such as the middle ear, inner ear, neutral pathways, or brain.
  •          The ability to recognize speech sounds.
  •          The history of exposure to loud noise and environmental
    or drug-related toxins that are harmful to hearing.
  •          Age.

A Common Problem in
Older Adults
Hearing loss is one of the most common conditions affecting
older adults. Approximately 17%, or 36 million, of American adults report some
degree of hearing loss.
There is a strong relationship between age and reported
hearing loss: 18% of American adults 45-64 years old, 30% of adults 65-74 years
old, and 47% of adults 75 years old, or older, have a hearing impairment.
Men are more likely to experience hearing loss than women.
People with hearing loss may find it difficult to have a
conversation with friends and family. They may also have trouble understanding
a doctor’s advice, responding to warnings, and hearing doorbells and alarms.

Types of Hearing Loss
Hearing loss comes in many forms. It can range from a mild
loss in which a person misses certain high-pitched sounds, such as the voices
of women and children, to a total loss of hearing. It can be hereditary or it
can result from disease, trauma, certain medications, or long-term exposure to
loud noises.
There are two general categories of hearing loss:
      Sensorineural hearing loss. This occurs when
there is damage to the inner ear or the auditory nerve. This type of hearing
loss is usually permanent.
      Conductive hearing loss. This occurs when sound waves
cannot reach the inner ear. The cause may be earwax build-up, fluid, or a
punctured eardrum. Medical treatment or surgery can usually restore conductive
hearing loss.

Tinnitus: A Common
Tinnitus, also common in older people, is a ringing,
roaring, clicking, hissing, or buzzing sound. It can come and go. It might be
heard in one ear or both ears and be loud or soft.
Tinnitus is a symptom, not a disease. It can accompany any
type of hearing loss. It can be side effects of a medication. Something as simple
as a piece of earwax blocking the ear canal can cause tinnitus, but it can also
be a result of a number of health conditions.
If you think you have tinnitus, see your primary care
doctor. You may be referred to an otolaryngologist, a surgeon who specializes in
ear, nose, and throat diseases(commonly known as an ear, nose, and throat doctor, or an ENT). The ENT will physically examine your neck,
head, and ears and test your hearing to determine the appropriate treatment.
Hearing Loss Can Lead
to Other Problems
Some people may not want to admit they have trouble hearing.
Older people who can’t hear well may become depressed or may withdraw from
others to avoid feeling frustrated or embarrassed about not understanding what
is being said. Sometimes older people are mistakenly thought to be confused,
unresponsive, or uncooperative just because they don’t hear well.
Hearing problems that are ignored or untreated can get
worse. If you have a hearing problem, you can get help. See your doctor.
Hearing aids, special training, certain medicines, and surgery are some of the
choices that can help with hearing problems.

Protect your loved Ones: Signs to Look For

If you know or care for an older adult, here are some
warning signs that may indicate they are the victim of financial abuse:
  •         There are unusual recent changes in the person’s
    accounts, including atypical withdrawals, new person(s) added, or sudden use of
    a senior’s ATM or credit card.
  •        The senior suddenly appears confused, unkempt,
    and afraid
  •        Utility, rent, mortgage, medical, or other essential
    bills are unpaid despite adequate income.
  •        A caregiver will not allow others to see the
  •        There are piled up sweepstakes mailings,
    magazine subscriptions, or “free gifts,: which means they may be on “sucker

Every state operates an Adult Protective Services (APS) program,
which is responsible for receiving and investigating reports of elder abuse,
neglect, and exploitation, and in most states, the abuse of younger adults with
severe disabilities.
APS is the “911” for elder abuse. Anyone who suspects elder
abuse, neglect, or exploitation should make a report. The reporter’s identity
is protected. APS services are confidential, so the reporter may not be able to
learn about the outcome of the case.
APS respects the right of older persons to make their own
decisions and to live their lives on their own terms. In cases of cognitive impairment,
however, APS will take steps to protect the older person to the degree
Source: www.ncoa.org

8 Ways to Protect Yourself from Scams

Millions of older Adults fall prey to financial scam every
year. Use these tips to protect yourself or an older adult you know.
1.       Be aware that you are at risk from
strangers and those closest to you.
Over 90% of all reported elder abuse is
committed by the older person’s own family members, most often their adult
children, followed by grandchildren, nieces, nephews, and others.
Common tactics include depleting a joint checking
account, promising but not delivering care in exchange for money or property,
outright theft, and other forms of abuse, including physical abuse, threats,
intimidation, and neglect of basic care needs.
Everyone is at risk of financial abuse.
Understand the scams that target seniors so you can spot one before it is too
2.       Don’t isolate yourself-stay involved.
Isolation is a huge risk factor for elder
abuse. Most family violence only occurs behind closed doors, and elder abuse is
no exception.
Some older people self-isolate by
withdrawing from the larger community. Others are isolated because they lose
the ability to drive, see, or walk about on their own. Some seniors fear being
victimized by purse snatchings and muggings if they venture out.
Contact your local senior center to get
involved and stay active.
3.       Always tell solicitors: “I never buy from
or give to anyone who calls or visits me unannounced. Send me something in
Don’t buy from an unfamiliar company and
always ask for what and wait until you receive written material about any offer
or charity.
Neighborhood children you know who are
selling Girl Scout cookies or school fundraising items may be an exception, but
a good rule of thumb is to never donate if it requires you to write your credit
card information on any forms.
It is also good practice to obtain a
salesperson’s name, business identity, telephone number, street address,
mailing address, and business license number before you transact business.
And always take your time in making a
4.       Shred all receipts with your credit card
Identity theft is a huge business. To
protect yourself, invest in and use a paper shredder.
Monitor your bank and credit card
statements and never give out personal information over the phone to someone
who initiates the contact with you.
5.       Sign up for the “Do Not Call” list and take
yourself off multiple mailing lists.
Be careful with your mail. Do not let
incoming mail sit in your mailbox for a long time. When sending out sensitive
mail, consider dropping it off at a secure collection box or directly at the
post office.
6.       Use direct deposit for benefit checks to
prevent checks from being stolen from the mailbox.
Using direct deposit ensures that checks go
right into your accounts and are protected. Clever scammers or even loved ones
have been known to steal benefits checks right out of mailboxes or from seniors’
homes if they are laying around.
7.       Never give your credit card, banking,
Social Security, Medicare, or other personal information over the phone unless
you initiated the call.
Misuse of Medicare dollars is one of the
largest known scams involving seniors. Common schemes include billing for
services never delivered and selling unneeded devices or services to
Protect your Medicare number as you do your
credit card, banking, and Social Security numbers and do not allow anyone else
to use it. Be wary of salespeople trying to sell you something they claim will
be paid for by Medicare.
Review your Medicare statements to be sure
you have in fact received the services billed, and report suspicious activities
to 1-800-MEDICARE.
8.       Be skeptical of all unsolicited offers and
thoroughly do your research.
Be an informed consumer. Take the time to
call and shop around before making a purchase. Take a friend with you who may
offer some perspective to help you make difficult decisions.
Also, carefully read all contracts and
purchasing agreements before signing and make certain that all of your
requirements have been put in writing. Understand all contract cancellations
and refund terms.
As a general rule governing all of your
interactions as a consumer, do not allow yourself to be pressured into making
purchases, signing contracts, or committing funds. These decisions are yours
and yours alone.

If you think you’ve been scammed, don’t be afraid or embarrassed to talk about it – waiting could make it worse. Immediately:

  • Call your bank and/or credit card company.
  • Cancel any debit or credit cards linked to the stolen account.
  • Reset your personal identification number(s).

Source: www.ncoa.org

Top 10 Scams Targeting Seniors

Financial scams targeting seniors have become so prevalent
that they are now considered “the crime of the 21st century.”
Why? This is because seniors are thought to have a
significant amount of money sitting in their accounts.
Financial scams often go unreported or can be difficult to
prosecute, so they are considered a “low risk” crime. However, they’re
devastating to many older adults and can leave them in a very vulnerable
position with little time to recoup their losses.
Review the list below, so you can identify a potential scam.
1.       Health Care/Medicare/Health Insurance Fraud
Every U.S.
citizen or permanent resident over age 65 qualifies for Medicare, so there is
rarely any need for a scam artist to research what private health insurance
company older people have in order to scam them out of money.
In these types of scams, perpetrators may pose as a Medicare
representative to get older people to give them their personal information, or
they will provide bogus services for elderly people at makeshift mobile
clinics, then use the personal information they provide to bill Medicare and
pocket the money.
2.       Counterfeit Prescription Drugs
commonly, counterfeit drug scams operate on the internet, where seniors
increasingly go to find better prices in specialized medications.
The danger
is that besides paying money for something that will not help a person’s
medical condition, victims may purchase unsafe substances that can inflict even
more harm. This scam can be hard on the body as it is on the wallet.
3.       Funeral & Cemetery Scams
There are
two types of funeral and cemetery fraud perpetrated on seniors.
In one
approach, the scammers read obituaries and call or attend the funeral service
of a complete stranger to take advantage of the grieving widow or widower.
Claiming the deceased had an outstanding debt with them; scammers will try to
extort money from relatives to settle the fake debts.
tactic of disreputable funeral homes is to capitalize on family members’ unfamiliarity
with the considerate cost of funeral services to add unnecessary charges to the
In one
common scam of this type, funeral directors will insist that a casket, usually
one of the most expensive parts of funeral services, is necessary even when
performing a direct cremation, which can be accomplished with a cardboard
casket rather than an expensive display or burial casket.
4.       Fraudulent Anti-Aging Products
Many older Americans seek out new treatments and medications to
maintain a youthful appearance, putting them at risk of scammers.
Whether it
is fake Botox or completely bogus homeopathic remedies that do absolutely
nothing, there is money in the anti-aging business.
Botox scams
are particularly unsettling, as renegade labs creating versions of the real
thing may still be working with the root ingredient, botulism neurotoxin, which
is one of the most toxic substances known to science. A bad batch can have
health consequences far beyond wrinkles or drooping neck muscles.
5.       Telemarketing
With no
face-to-face interaction, and no paper trail, these scams are incredibly hard
to trace. Also, once a successful deal has been made, the buyer’s name is then
shared with similar schemers looking for easy targets, sometimes defrauding the
same person repeatedly.

Examples of
telemarketing fraud:

“The Pigeon Drop”
The con
artist tells the individual that he/she has found a large sum of money and is
willing to split it if the person will make a “good faith” payment by
withdrawing funds from his/her bank account. Often, a second con artist is
involved, posing as a lawyer, banker, or some other trustworthy stranger.

 “The Fake Accident Ploy”
The con
artist gets the victim to wire or send money on the pretext that the person’s
child or another relative is in the hospital and needs the money.
“Charity Scams”
Money is
solicited for fake charities. This often occurs after natural disasters.
6.       Internet Fraud
While using
the internet is a great skill at any age, the slower speed of adoption among
some older people makes them easier targets for automated internet scams that
are appearing on the web and email programs.
Pop-up browser windows simulating virus-scanning software will fool
victims into either downloading a fake anti-virus program (at a substantial
cost) or an actual virus that will open whatever information is on the user’s
computer to scammers.
Examples of Email/Phishing Scams:
  • A senior
    receives email messages that appear to be from a legitimate company or
    institution, asking them to “update” or “verify” their personal information. 
  • A
    senior receives emails that appear to be from the IRS about a tax refund.

7.       Investment Schemes
Because many
seniors find themselves planning for retirement and managing their savings once
they finish working, a number of investment schemes have been targeted at
seniors looking to safeguard their cash for their later years.
8.       Homeowner/Reverse Mortgage Scams
like to take advantage of the fact that many people above a certain age own
their homes, a valuable asset that increases the potential dollar value of a
certain scam.
An example
of a property tax scam is when scammers send personalized letters to different
properties apparently on behalf of the County’s Assessor’s Office. The letter
can be made to look official, but displaying only public information. The
information would identify the property’s assessed value and offer the
homeowner, for a fee, to arrange for a reassessment of the property’s value and
therefore the tax burden associated with it.
9.       Sweepstakes & Lottery Scams
With this
scam, the scammer informs their person(s) of target that they have won a
lottery or sweepstakes of some kind and need to make some sort of payment to
unlock the supposed prize. Often, seniors will be sent a check that they can
deposit in their account, knowing that while it shows up in their account
immediately, it will take a few days before the fake check is rejected.
During that
time, the criminals will quickly collect money for supposed fees or taxes on
the prize, which they pocket while the victim has the “prize money” removed
from his/her account as soon as the check bounces.
10.   The Grandparent Scam
Grandparent scam is so simple and so devious because it uses one of older
adults’ most reliable assets, their hearts.
will place a call to an older person and when they pick up, they will say
something like: “Hi Grandma, do you know who this is?” When the unsuspecting
grandparent guesses the name of the grandchild the scammer most sounds like,
the scammer has established a fake identity without having done any background
Once “in,”
the fake grandchild will usually ask for money to solve some unexpected
financial problem to be paid via Western Union or MoneyGram, which do not
always require identification to collect.
While the
sums from such a scam are likely to be in the hundreds, the very fact that no
research is needed makes this a scam that can be perpetrated over and over
again at very little cost to the scammer.
If you feel
you have been a victim of a scam, contact your local police office.

10 Ways to Deal with Caregiver Stress

When you are caring for others, it is
critical that you first take care of yourself. By not doing so, you put
yourself at risk for exhaustion, health problems and even total burnout.
These 10 tips will help keep your stress in
1.       Put you physical needs first. Eat
nutritious meals. Do not give in to stress-driven urges for sweets or overindulge
in alcohol. Get enough sleep; if you have trouble sleeping at night, try
napping during the day if you can. Schedule regular medical checkups. Find time
to exercise, even if it means you have to ask someone else to provide care while
you work out. If you experience symptoms of depression talk to a medical
2.       Connect with friends. Isolation
increases stress. Getting together regularly with friends and relatives can
keep negative emotions at bay.
3.       Ask for help. Make a list of things you
have to do and recruit others to pitch in. Even relatives and friends that live
far away can manage certain tasks.
4.       Call on community resources. Consider asking
a geriatric care manager to coordinate all aspects of your loved one’s care.
Other service providers, including home health aides, homemaker and home repair
services, can shoulder some of the many responsibilities of caregiving.
5.       Take a break. You deserve it. Plus your
ailing family member might benefit from someone else’s company. Think about
respite care by friends, relatives, or volunteers. You can also try a home
health agency, nursing home, or assisted living facility; these facilities
sometimes accept short-term residents. Adult day care centers, which usually
operate five days a week, provide care in a group setting for older adults who
need supervision.
6.       Deal with your feelings. Bottling up
your emotions takes a toll on your psyche and even on your physical well-being.
Share feelings of frustration with friends and family. Seek support from
co-workers who are in a similar situation or a caregiver support group.
7.       Find time to relax. Doing something you
enjoy, such as reading, walking, or listening to music can recharge your
8.       Get organized. Simple tools like
calendars and to-do lists can help you prioritize your responsibilities. Always
tackle the most important tasks first, and don’t worry if you can’t manage everything.
9.       Just say no. Accept the fact that you
simply can’t do everything! Resist the urge to take on more activities,
projects, or financial obligations than you can handle. If someone asks you to
do something that will stretch you too thin, explain honestly why you can’t and
don’t feel guilty.
10.   Stay positive. Do your best to avoid
negativity. Hold a family meeting or call an elder care mediator to resolve
conflicts with siblings and other relatives. Instead of dwelling on what you can’t
do, pat yourself on the back for how much you are doing, and focus on the
rewards of caring for someone you love.

8 Rules for New Caregivers

1.       Start with a candid conversation. Talk
with your parents about how you will be helping them meet their needs. Unless
they are severely incapacitated, they should continue to make their own
decisions and remain a central part of all discussions about their care.
Encourage them to articulate their concerns. Have an open conversation about
what role your parents want you to play. Establish limits so they don’t form
unrealistic expectations.

2.       Set your priorities. Make a list of
what needs to get done and how you plan to do it. An organized approach puts
you in control, reduces stress and endures that your parents get the assistance
they need. Be sure to create back up plans, and ask others to serve as
reinforcements if necessary. Write down your plans and schedules, and give a
copy to all involved family members.

3.       Build a support network. In most families,
one person assumes the role of primary caregiver. But that does not let others
off the hook. Enlist the help of your siblings, but also consider that cousins,
nieces, and nephews may be eager to help. Don’t forget to include your friends,
distant relatives, neighbors, and acquaintances. Not all will volunteer to
help, but many will get involved if you ask. Some, in fact, may feel hurt or
left out if you don’t seek their assistance.

4.       Don’t be afraid to delegate. Ask a
friend to pick up groceries or get books from the library, a neighbor’s child
to adopt your parent as a grandparent, or a local teenager to help with yard
work for a manageable fee. Ask the newspaper carrier or apartment superintendent
to keep an eye out for your parents and to call you if anything seems wrong.

5.       Offer alternatives. With family
members, don’t accept excuses for not helping without offering alternatives. A sibling,
who lives far away, for example, can help with paying bills, contacting doctor’s
offices, or seeking support from local agencies. Siblings who have young
children can cook or bring kids along for visits and outings.

6.       Hold family meetings. Schedule them
regularly, and bring in distant family by phone. Choose a neutral party to moderate
if necessary. Draw up a clear agenda for each meeting, and agree on rules of
conduct for instance, don’t interrupt, stick to time limits, avoid argument and
focus the discussion on how to care for your parents. If meetings tend to be
contentious, consider hiring a geriatric care manager to run the meeting.

7.       Involve you children. When you have
parents and children who need your time and attention, you may feel pulled from
both sides. Be honest with your children about the situation, and listen to
their concerns. Encourage their questions and answer them thoroughly. Make time
for fun activities, and request your children’s help. Teenagers can drive
Grandma to the store, and even a toddler can make her feel loved.

8.       Talk to your spouse. Have a discussion
with your partner about your caregiving responsibilities. What role do you
expect him or her to play? Suggest specific ways your spouse can help, and show
appreciation for his or her efforts. Recognize that your responsibilities
affect your spouse, and encourage him or her to talk about any frustrations.
Your relationship is a priority, keep it that way.

The Top Caregiving Challenges

Many of us will become the caregiver of a parent or loved
one. It is a rewarding endeavor, but it can be filled with enormous challenges.
Be prepared by recognizing some if the difficulties that caregivers encounter:
  •          Time management: Caregiving takes time. As a result, caregivers have less time
    for other family members and themselves.


  •     Competing
    Balancing caregiving responsibilities with the demands of a job
    can be difficult. Tasks, such as calling doctors, checking in with social workers,
    arranging services, and scheduling appointments can entail many daytime hours. That
    is why the majority of caregivers say they need workplace accommodations such
    as going in late, leaving work early, or taking time off.


  •     Financial
    The costs linked to caregiving add up. A study by the
    National Alliance for Caregiving found that the out-of-pocket cost for
    caregivers is roughly $5,500 per year. That includes food, travel, transportation,
    medical insurance co-pays, and medications. Long-distance caregivers had even
    higher estimated expenses, at about $8,700 per year.


  •        Physical
    and mental stress:
    For those providing intense care for long periods, the
    physical and mental tolls can be heavy. Although most caregivers don’t
    attribute health problems to caregiving, some say they feel frustrated,
    exhausted, angry, or sad. 

Source: www.aarp.org

Did you know HEALTH FACTS:

Sleep problems
can be eliminated by minerals, especially calcium and potassium.
Every minute of
the day someone has a stroke. Stress is the major cause of cancer, heart attack
and stroke.
One fifth of the
“vegetables” Americans eat today are French fries and potato chips.
Radiation of
foods kills the nutritional value. Freezing causes 40% loss of nutrient value.
Antacids contain
aluminum which blocks the system necessary to detoxify our body. Resulting in
increased allergies and weight gain. Continual use of ant-acids destroy the
body’s ability to digest food.