Nursing homes: How to get your feet wet

Most people start to look for a nursing home in the midst of an emergency situation, which is not the time to make an important decision. Make an appointment to visit a nursing home or two to see if you or a loved one enjoy the facility. This will give you the opportunity to ask any questions, including detailed questions about cost, insurance, and payment.

Your visit will also serve to calm any doubt or nerves that may exist around living in a nursing home. As with most things in life, it is the unknown that is more frightening than reality. Most people tour a nursing home and find that its comforts are not too different than those at home, and that the environment can provide much needed socializing.

The first thing to consider when selecting nursing home candidates for short-term or long-term care is which specialty care options you or your loved one may require. Some nursing homes specialize in Alzheimer’s and dementia care, others may cater specifically to residents who are going through rehabilitation, and others may not have a concentration at all.

During your visit, ask to stay for lunch or dinner. Dining during a meal service is the best way to see (and taste) the food that will make up all or most of your meals for an extended period of time. Staying for a meal also helps you see how meal service works (time, frequency, etc.) at the home, as it may vary from facility to facility. Some nursing home allow residents to eat any time, within reason, while others serve meals at set times. Some people do well on a set schedule and benefit from that routine; however, others prefer to exercise choice at any given time and want the option of dining at any time.

Pay attention to the other residents and how they pass their time. A nursing home should have some recreational activities for residents, depending on the intensity of care being provided. If you will potentially have an extended stay and require long-term care and require a familiar environment, ask if residents are allowed to personalize the bedroom with personal effects.

Before making any final decisions, get information straight from the source. Ask residents who you meet on your tour what they think of the home; what are the pros and cons? What do they love and what do they want to see changed? When you get home, search reviews to see what different people are saying about their experience with the home.

Tips on getting ready for autumn for the elderly

Elder Care Assistance

Helping Elderly Prepare for Fall Temperatures

Fall has come early in the Midwest and it’s a reminder that this summer has been all too short. This means that it’s time to start preparing for autumn, and that goes double for elderly people living alone or in other home arrangements.

The beginning of autumn brings a spike in season-related falls and illnesses as the changing weather sets in. When the temperature drops, we tend to stay indoors more, but still spend a lot of time outdoors during the early months. This requires twice the preparation, which can be difficult for elderly people that live on their own and have to maintain property.

Still, fall can be a really fun and beautiful time of year for everyone, the key is to take these steps to get ready.

Seasonal vaccines

Cold and flu season starts in the fall and with temperatures already dipping and people staying indoors, seasonal illnesses start early too so get your seasonal flu vaccine. Wash your hands carefully with hot, soapy water for at least 30 seconds to control the spread of germs. Youshould also get plenty of sleep, like the rest of the year, to keep your immune system strong and you healthy.

Home care

Elderly people that live alone should hire a specialist to check on their heating systems. Regardless of the living situation, now is a good time to pick up a space heater or two in case you feel chilly in an otherwise warm place. Make sure you never leave them unattended and leave at least three feet between it and a wall or curtains. Whether an elderly person lives on their own or in an assisted living community, it can take more time to get these types of errands accomplished so it’s a good idea to get started early in the season.

Outdoor precautions

Summer has the reputation of being the season of yard work and outdoor activities, but autumn is still warm enough to enjoy time outside. The season can pose some obstacles in that rains create slick surfaces and falling leaves can contribute to unsafe conditions. There can be a lot of work involved with maintaining a safe outdoor space and walkways during autumn, so it’s best to hire a landscaping service to rake leaves and perform last trims before the winter. This way you can help prevent debris on your walkways and steps, but it’s important to still be careful when outside.

Obama administration poised to usher in new nursing home regulations

Elder Care Nursing Home

US Government’s Renewed Commitment to Elder Care

Many news stories that have been in the media lately have focused on what appears to be the United States’ government’s renewed commitment to elder care. Organizations are calling for improved nursing home administered to Medicaid and Medicare beneficiaries, and the Obama administration is hearing them loud and clear.

There are approximately 1.5 million Medicare and Medicaid beneficiaries in the U.S. that are receiving treatment across 15,000 long-term care facilities and nursing homes across the country. The new care proposal is a whopping 403 pages and it aims to reduce (and hopefully eliminate) unnecessary hospital readmissions and infections while improving quality of care and safety. Barack Obama announced a new set of rules and regulations at the White House Conference on Aging.

A document of this size surely has a lot of information and supporting data, but the highlights are already pleasing nursing home residents and others who have held off moving to a long-term care facility due to fear. Regulatory changes include ensuring that staff members are properly trained in dementia care and preventing elder abuse, improved care planning (including discharge planning) that involves an interdisciplinary team, and a thorough follow up including instructions to new facilities (in cases of a transfer).

This new proposal touches on another factor that is often overlooked. There are more controls put in place now to ensure that nursing home and long-term care residents are not unnecessarily prescribed antipsychotic medications. The over prescription of unnecessary antipsychotic medications can lead to death and other serious health and mental problems.

The new rules were proposed by CMS, the leading payer for long-term care in the U.S. Overall, nearly 64 percent of nursing home residents are covered by Medicaid, 14 percent are covered by Medicare, and the remaining 22 percent are covered by another payer. The new proposal would likely cost the nursing home industry around $729 million in the first year of its implementation, and $638 million in the second year.

Although senior advocacy groups and residents alike are thrilled with the possibility of widespread reform, some are not as excited. For one, these measures do little to address the chronic problem of nursing home staffing – particularly the understaffing and overworking of employees that leads to burnout symptoms like exhaustion and apathy.

Notes on these new rules are not due until mid-September so it appears that this is going to be a long process, like most things in government. For now, it is up to every nursing home and long-term care facility provider to hold themselves accountable for the quality of care they offer and raise the bar.

Congress turns focus to nursing home staffing with new bill

Nursing Home Staff

Registered Nurse Nursing Home Staffing

A bill recently introduced to Congress by Illinois Rep. Jan Schakowsky is one that is being celebrated by residents of nursing homes and their families. The representative introduced Put a Registered Nurse in the Nursing Home Act (H.R. 952) in February, which would mandate that skilled nursing homes that receive federal reimbursements from Medicare or Medicaid to staff a direct-care registered nurse at all times – 24 hours per day, seven days per week. At this time, the requirement is to staff one direct-care registered nurse for at least eight hours during a 24-hour period, regardless of the size of the home.

So far, 11 representatives from eight states have cosponsored the bill. Although the list is growing, with three more sponsors joining the list in June, so far only congressmen and congresswomen from the Democratic Party have back this effort. Not surprisingly, national and local nursing associations and consumer advocates are championing this bill, as well. In her statement half a year before the bill was formerly introduced to Congress, Rep. Schakowsky wrote in a press release:

“Putting a loved one in a nursing facility is always a difficult decision. We must ensure that seniors and the disabled in nursing homes are not harmed because there is no RN on site to take care of their needs. Every American deserves the right to age with dignity and respect, and I urge my colleagues to support the Put a Registered Nurse in the Nursing Home Act in order to guarantee proper care for our loved ones who reside in nursing homes nationwide.”

This news excites many people because, at times, there can still be a stigma regarding the level of care and quality of life in a nursing home. It is crucial to consider factors such as staffing and access to medical professionals in an emergency when choosing a skilled nursing home to entrust your wellbeing or that of a loved one. The Put a Registered Nurse in the Nursing Home Act strives to alleviate the worry for families and ensure that this level of care is provided to everyone. Luckily, those that are currently living in a home that focuses on quality around-the-clock care will likely not notice a difference.

Currently, the Put a Registered Nurse in the Nursing Home Act bill is making its way around various committees. The last significant update on the status of the bill was shortly after its announcement in February 2015 and no official vote date has been set.

Changes to Medicare’s Nursing Home Rating Means A Lot to Residents and Families

In 2008, Oregon Senator Ron Wyden started an initiative to have Medicare set nursing home rating because there was not a lot of information available to people that were turning over their lives, or the lives of their loved ones, to nursing home facilities. The rating system is kept simple with grades ranging from one to five stars (five stars being the best). The rating is calculated based on three categories:

1. Health inspection ratings
Health inspection ratings make up the key component of the rating. Health inspection ratings are based on comprehensive inspections that use federal inspectors and state inspectors to evaluate a nursing home on 180 different factors.

2. Quality measures
Quality measures are based on the data about the health and care of the nursing facilities’ residents. This number tracks things like the percent of residents who have contracted UTIs, who have pressure ulcers, and who are prescribed antipsychotic medication. Overall, there are 18 quality measures for long-term skilled nursing facilities.

3. Staffing ratio
This is the number of residents for each staff member. This number is two-fold. It includes the number of residents per staff member, and also the number of residents per trained nurse.

However, this rating system still left many concerns that lawmakers addressed in October 2014 with the Improving Medicare Post Acute Care Transformation Act of 2014, and more updates to the act have just been released. New changes include:

  1. Higher standards for several quality measures
  2. Changes to the algorithm that calculates staffing ratio
  3. Confirmation of staffing ratio data via nursing homes’ payroll data
  4. New quality measures (for example, the inclusion of antipsychotic medication prevalence)
  5. Expanded federal oversight of state inspectors
  6. Increased frequency of quality and federal inspections

These changes are sure to raise the bar of the care provided to nursing home residents and will help families choose the best home for their loved ones.

Nursing home provides specialized care for seniors with dementia

Nursing homes provide specialized care for seniors with dementia

Modern medicine and healthcare practices help many people live longer than the average lifespan of even the past of few years. However, in societies where living well into the 80s and 90s is common, the fears of dementia and nursing homes grow. Of course, the prospect of having dementia is frightening on many personal levels, it also seems that many people are uncomfortable with the idea of living in a nursing home.

Although there have been cases in the news of nursing home abuse, the reality is that nursing home communities are safe, comfortable places that support the changing needs of a quickly aging population. Across the country, nursing home communities have made great strides in developing a strong culture, creating a homelike environment, and adopting other resident-centric practices. The goal is to provide individualized care effectively and consistently.

There are more than 15,000 nursing homes in the U.S., which can accommodate around 1.7 million residents. Although nursing home residents can have varying health conditions, nearly 70 percent of all Americans with advanced dementia live in nursing homes. In the coming years, nursing home use is expected to increase dramatically.

Placing a loved one in a nursing home can also be a difficult time for family and friends. Family members often try to hold off visiting a nursing home because they feel guilty and think they should be able to take care of their loved ones. In reality, dementia and other issues that come with advanced age are conditions best cared for by trained professionals who can be always present. When you start to look at nursing home living as a necessary and even pleasant experience, then you can start to make the most out of this care.

Family and friends will always play a big role in their loved one’s care. Resident and family preferences often drive the care received and medical decisions made. People with dementia are not usually able to make big decisions alone, especially regarding their care. Make sure to be their biggest advocate and communicate their needs. If your loved one can still make these decisions, have the difficult conversation of their wishes. What type of care do they want? Do they want a feeding tube if they can no longer swallow? Do they want medical treatment administered at a hospital or in the nursing home, if possible? Do they want extraordinary measures taken in prolonging life? Together, the nursing home and family can ensure the best care for a resident with dementia.

Meet the staff: Volunteers

Role of volunteers in elderly care

It takes a lot of people to provide the best care for the elderly, both medically and personally. When you look around the nursing home, you see an abundant team made up of healthcare professionals and aids. An important part of this team is the dedicated volunteers.

Volunteers can hold a variety of positions, from assisting with providing medical care to the more common social visits. Volunteers provide entertainment and companionship for the elderly, contributing to long-term welfare by spreading cheer. Nursing home residents love volunteers for this, as it becomes lonely from time to time.

Volunteers come from all walks of life and their contributions to a nursing home usually reflect that. Stylists come to donate their time by giving residents a new hair do, high school theater troupes come to perform skits or sing songs, and more. Most importantly, volunteers offer a human connection that has nothing to do with medicine or illness, giving residents reprieve from being patients. Sometimes a visit is as simple as a volunteer playing cards with a group or reading a story to a resident.

Nursing homes offer fun activities to give residents this much-welcome break, but volunteers add another component. Human companionship is vital, making volunteer visits so special. Their roles are so important that nursing homes sometimes host volunteer recruitment events. Next time you visit a loved on in a nursing home, pay attention to the vibrant community of the facility.

BRIA Celebrates CARF Accreditation

CARF Accreditation for BRIA Health Services

BRIA Health Services is proud to announce that we recently earned CARF accreditation for two of our locations in Geneva and Westmont with all of our locations poised to be accredited in 2015. We congratulate our team on its timeless commitment to quality service and care, but you may be wondering what CARF certification is, anyway.

CARF International is an independent, nonprofit accreditation organization that specializes in the measure of standards in service and business practices for the health and human services sector including skilled nursing facilities. In the last 48 years since it was established, CARF has accredited more than 50,000 programs across 23,000 locations in North America, South America, Europe, Africa, and Asia. This accreditation means a lot for the programs that receive it, as well as for the people the programs serve. After all, more than 8 million people are served annually by CARF-accredited service providers.

In order to receive CARF accreditation, BRIA had to prove its commitment to quality improvement, to the needs of our residents, and to the continued analysis of our effectiveness.

The accreditation process begins with CARF administering an on-site survey conducted by CARF’s expert practitioners. CARF applies a series of internationally recognized standards to determine a program’s value. The subsequent report highlights the service provider’s strengths while marking areas of needed improvement. CARF grants the accreditation if the provider conforms to the standards set by the organizations and respected throughout the world.

But it doesn’t stop there. CARF accreditation is special because it is not enough to provide excellent and effective services for residents and patients. CARF accreditation signifies a provider’s continued commitment to growth, improvement, and never settling. Each year during the term of the accreditation, service providers must submit a Quality Improvement Plan (QIP) to CARF that shows how it will address the marked areas of improvement and the changes it has made thus far.

BRIA is proud of our team for this accomplishment, but it’s nothing we didn’t know already. The BRIA team and our residents and their families have long known our dedication to providing top quality services.

When in Rome: Foreign Cultures and American Nursing Homes

Foreign cultures and American nursing homes

“We don’t do that.” How many times have you, as an immigrant or the child of foreign parents, said this about nursing homes? In many foreign cultures, it is unacceptable to place a parent into an assisted living facility because it is considered abandoning the parent and failing your responsibility as a child. However, an assisted living home can improve the parent’s quality of life and longevity. This is a cultural barrier that, due to modern lifestyles in the U.S. and other factors, you and your parent can cross together.

The first step is coming to the decision that an aging or ailing parent can no longer care for themselves or may need immediate assistance at all hours of the day. Once you have decided that your parent can’t live alone anymore, your next thought may be to bring your parent into your home to live with you. In a bustling city like Chicago in the modern age, people have to be active around the clock to maintain their lifestyles, which often does not leave a lot of time for providing attentive, around the clock care to elderly parents. Instead of looking at this decision as one that would hurt the parent, consider what you are willing and capable of providing, including skilled medical care. Let go of any guilt and see the benefits of an assisted care facility.

Now it is time to have this talk with your parent. In this case it is important to act as your parent’s advocate and not add pressure to an already difficult and oftentimes scary situation. Big life changes are difficult at any age, especially to someone in their later years. Express concern, not anger, to win them over. No parent wants to be a burden and this way your mother or father can listen to you as a friend. Ask your parent to come with you to view the facility and reveal that the scary place behind the curtain is actually a gentle home with around-the-clock care and attention, and a strong social life. This way you can dispel the myth of “dumping” your parent in a nursing facility.

While there are no magic words to convince your parent that this is best for them, the best advice is not to use force. This decision is best made by the parent when they are ready, and although you have to be vigilant on the matter, you may have to wait for things to get worse before they get better. Unfortunately, this may mean them forgetting to pay their bills, falling, or experiencing anything else that sends an alarm that they need help.

How to Choose a Long-Term Care Facility

ScalesYou have finally tackled the difficult decision of going to or placing a loved one in a long-term care facility. Many individuals and families often struggle with this choice because they are uninformed of the opportunities and risks. It is an important decision about where you will live, who will be caring for you, the cost of these services, and with whom you will share your community. Below are steps to choosing a long-term care facility, and what you need to consider when doing so.

1. Determine your needs

Long-term assisted living facilities can offer many different services and care options so it is important to find a facility that serves your specific needs. Assisted living is for those who need help with a few daily living activities, like bathing or dressing. Skilled nursing is for those who needs a nurse on a daily basis, are bedridden, or are suffering from more complicated behavior issues. This does not include dementia or Alzheimer’s disease, which falls under memory care.

Some long-term care facilities, like BRIA, provide many levels of care in one place. This is an exceptionally good option for people starting out in a senior-care residence and want to stay in place as their needs progress, instead of looking for a new home and caretakers as health conditions change.

2. Determine your price range

Assisted living costs vary as much as the services themselves. On average, long-term assisted living care can cost $3,600 per month, memory care is around $4,700 per month, and skilled nursing is usually from $6,700 per month and more. Health insurance and Medicare do not cover long-term care, but can be used to subsidize other costs, like medication. More than half of the states in the U.S. do not permit for Medicaid to cover long-term care costs, and in the states that it is offered, there are strict guidelines (like you have to be deplete nearly all of your money and possessions) and long wait times.

How to choose a long-term care facility

3. Start the search

Now that you have laid out your parameters and know what you want and need, it’s time to find the facility that will deliver.

Research the history

The facility you choose for your next home or the home of a loved one should have a good track record of providing care and supporting its residents. Staff members should be properly trained and have current certifications. Be sure to research any complaints against the facility and if they were recent. This is where safety red flags would pop up.

Visit in person

A virtual tour is lovely, but it is vital to visit in-person. You will be able to determine first hand the quality and convenience of the neighborhood, ease of mobility, and condition of the facility. This will also allow you to meet current residents and their families. Do they like the facility? What do they dislike about it? What are the problems, if any, with staff members? While you’re visiting, meet with the staff, as well. Look to see if the staff gets along, if they seems rushed or stressed. Are they friendly and attentive? How long have they worked at the facility? A high staff turnover or being chronically understaffed can have negative effects on residents’ care. Most importantly, ask a lot of questions!