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Question of Month

10 Things Assisted Living Homes wont tell you!

10 Things Assisted Living Homes wont tell you!!  Smart money tells you what to watch out for when dealing with an Assisted Living Sales Person. We generally take a more postive view and talk about focusing on continuity of care and complete care but felt this was right on and wanted to share it. We especially note how seniors and their families are mislead by their views that they need only a little help and avoidance of the fact that they will need much more care in the very near future if they need any assistance today. If they dont need assistance and there is no reason they are looking for an "assisted" care setting then one might ask why are you looking?  What we see is the Assisted Living sales force promising what other caregivers will do for them.  However, the details of there are 3 caregivers covering 50 residents in a large area is a detail that is missed. Smart money notes that Assisted Living is a short term fix.  That is because they cost alot for the limited care they provide and when the increased care needs come many are forced to move.  Also in general Assisted Living has 1 administrator in charge of 150 sick people.  Common Sense tells us that the level of direct protective supervision might be in question. Assisted living and home care generally are the lowest values for senior care dollars. They prey on a seniors desire to remain indepenent and young and falsely advertise that they can keep them living at home or in a hotel type care settings. Those are just not reasonable assumptions. Seniors need to be cautious of all care settings and spend time looking for continuity of care. Read the 10 Things Assisted Living Homes wont tell you by smartmoney and let us know which ones you like or add your own. How do you balance cost and value? While reducing staff helps the businesses bottom line is that helping you get the most care, best care, and continuity of care you want? Is that a good value for you? Help us spread the word.  Click for Free Ways to help. It is up to you to make this viral!   Two examples of great value for your senior care dollars.  Both offer continuity of care! Tender Loving Care Senior Residence - Great alternative to Assisted Living In Las Vegas and Home Care In Las Vegas for heavy care needs, memory care, dementia care and Alzheimer's Care. Tender Loving Care Senior Residence, Costa Brava - Great Assisted Living in Las Vegas and Home Care in Las Vegas for more active seniors transitioning to needing assistance.  Both offer high levels of continuity of care. Dr Shawn McGivney

ALZHEIMER’S and DEMENTIA CARE COST MORE THAN CANCER OR HEART DISEASE!

CNNMoney reports on a New England Journal of Medicine article that notes the cost of Alzheimers  and Dementia care is already more than the cost of heart disease and will continue to rise. Read the article here Dementia Care costs top $100 billion The headlines are clear. A new study puts the cost of treating Alzheimer's and other forms of dementia at $109 billion, making it more expensive to society than either cancer or heart disease.  Moreover, the current crisis will continue to grow rapidly as the baby boomers in America age.  What is less clear is the answer to that question of how to provide the care, in a humanistic and family oriented way, at a reasonable cost.  We want to suggest THE CURE TO THE INDIVIDUAL AND GLOBAL HEALTH CARE CRISIS. TLCSR is the pilot study that answers the question!  By focusing on continuity of care, people including care team, residents and family society benefits and the care provided is socially more complete.  That is how you get the best value for Senior Care dollars and fix the problem of the global and individual health care crises.  More good news is you dont have to wait for the goverment to help you find the Best, Most Cost Effective, Alzheimer's and Dementia Care.  You can do it yourself right now!  Visit Tlcsr.com and tlcsr2.com to find out what to look for in all Senior Care Settings. How can Continuity of Care and the TLCSR model of care be the cure for both the individual and global health care crises? Our plan cures the issue not only of Dementia Care and Alzheimer's care but helps fix the individual and global health care crisis.  We have seen a mis use of funds away from the direct care system to sub specialities many of whom say " I only do this or that."  That disjointed level of care leads to expensive and less comprehensive care.  A la Cart billing is good for the CEO, Stock holder and the companies bottom line but the servcie buffect, in-kind services, and mothers family style care is better for getting care when needed.  We are not blaming any one person since everyone has participated in getting where we are.  Doctor, Families, Individuals, insurance companies and the government.  What is needed is a better understanding of what care is.  How many of us have at one time or another under valued a caregiver, a mother, a domestic worker, who cares for us?  I have at times felt that as the "skilled" doctor I was smarter, better, than someone less educated.  By doing years of direct care for my own parents mother and  now father I see that caregiving is a skill!  Indeed, my wife and sister do it differently and in many ways better than I do.  Now after 10 years as a direct caregiver I am a much better caregiver.  My view is very unique in that few doctors are given the change to do direct care. Care does include emotional and social care. Feelings are the final expression of all Health care no mater what the label.  Indeed most studies specifically exclude feelings, emotional health, social and financial variables since they cant study them.  Even if we cant study them they are the most improtant factor in work, productivity, feeling good, family and social wellness.  Read our post on care vs caring or how are physical care and caring different as other reading. These are not the total answer but they start to provide guidance as to how we can value each other, family, mothers and caregivers more and in turn get more caring and value for our health care and life spending. Tender Loving Care Senior Residence advertised Continuity of Care and complete care and not just urgent care or quick care. Indeed, do you want a quick fix or heart felt care from someone who is INVESTED IN YOU FOR THE LONG RUN? A hospitalist who cares for you for a week, then another doctor in rehab for a week, then ...  In all cases you have to be your own doctor and coordinating the care.  While you know how you feel you probably do not really know which tests you would pay for if you were spending your own money.  The tests with the best value physically and emotionally to you.  You are not a doctor, you do not know how to quantify risk, benefit, or cost. Did you know it is cheaper to buy many medications for cash, out of pocket than, to pay just the copay?  Yes, the co pay alone is more than paying cash!  Why you ask.  The systme makes more money. You have almost no way to know the details of what is needed, and the magnitide of the risks and benefits of your choices even if you are informed. That is why you need a doctor.  The probloem is the doctor directly or indirectly works for someone other than you. The relationsnip with you and the doctor is indirect and short lived. Continuity of care can help all get more care, better care, for a better price or value. That is especially true in Dementia Care where the care team is the best treatment for Dementia. Find the most continuity of care and complete care, find the best individual members of your care team and you will get the best value for your Senior Care dollars. WE NEED YOUR HELP! THIS AFFECTS ALL OF US RIGHT NOW BY AFFECTING AT LEAST ONE PERSON IN OUR EXTENDED SOCIAL CIRCLES AND EACH OF US INDIVIDUALLY AS THE BABY BOOM WASHES OVER AMERICA. Help spread the word.  Make this viral!! Help us spread the word.  Click for Free Ways to help. Click for The Best, Most Cost Effective, Dementia and Alzheimer's Care!. Dr Shawn McGivney

Save money on Dementia Care-Value The Caregivers!

Value the individual members of the Dementia Care Team more than Pills Why do writers generally under value Dementia Care caregivers, social and behavioral treatments when listing Dementia Treatments.?  Most of the time they list the pills and just gloss over get the care by saying “get home care”.   All home care is not the same even if it costs the same. People vary a lot in many socially and emotionally important ways.  Relationships have many sides-- the customer, Customers Family and Social System, the individual caregivers, and the entire care team. Value People and you will get the best, most cost effective, care by getting many in-kind less tangible to the researcher’s studies things.  Love, Compassion, Continuity of care, reliability, sacrifice, are relationship words that have value and should be valued. Both sides need to value the other, it is a two way street. Mayo Clinic Blog Here is a shout out from the mayo clinic blog to thank those caregivers who are the treatment. Alzheimer’s disease by Angela Lunde http://www.mayoclinic.com/health/dementia-caregivers/MY01963 Dr McGivney’s Thoughts Find the best, most socially skilled caregiver team you can, the most continuity of care, to get the best care in life. Family offers a lot of continuity of care.  We value them and get a lot in return emotionally and socially if not financially.  Even if you do not use the family social system today, there is a big value we get by knowing we have that back up a social system provides us.  Remember those issues when you are sick and looking for “help”, medically or financially, for “home care”, Assisted Living care or Dementia Care, Alzheimer’s Care, or Memory Care. Value the caregivers, mothers, friends, and paid caregivers.  Value continuity of care and you will get a lot more than you pay for in dollar terms. That is how you get value in health and Dementia Care. Share your comments, like and make this viral!! Help us spread the word.  Click for Free Ways to help. Click for The Best, Most Cost Effective, Assisted Living and Senior Care Alternatives. By Dr Shawn McGivney

Dementia Care-Exercise, social interaction may trump meds for Dementia Care

I am glad that medicine is starting to study Dementia Care and emotional health and wellness as much as they are able.  Many many not know that most studies SPECIFICALLY EXCLUDE FEELINGS, SOCIAL INTERACTIONS AND WHAT DOCTORS CALL TRANSFERENCE.  I understand why they do so.  They do so to allow them to focus on variables they can monitor, understand, and quantify.  The problem is that feelings and humanisms, social interactions are way to complicated and multi facited to study.  Love, Hope, Feelings productive, needed, wanted and belonging while essential to humanism and feeling good are very hard to define and quantify.  We all can agree that a picture is worth 1000 words and feelings are invaluable.  Symblols help us to see but social experience, education, enviroment, social values and many other things are needed for each person to produce that unique invividual feeling. Read this article and then read my comments on the post.  Do you see how one might use this good research to modify how they look for Assisted Living and Senior Care? Novel Exercise Program May Trump Meds for Dementia Great article by Caroline Cassels  that confirms what common sense has told us for a long time. People, all people, have feelings, emotional needs, and being more attentive to them can help all people including people with Dementia Feel better. At one level that is scarey. That the science doctors think is complete, their studies, actually fail to include the most powerfull variables to feeling good and getting better where better is feeling better.  I often think of the power of family when I recall the old women who one minute is crying in pain from a broken arm, total body arthritis, and bone mets and then just seconds later, has no pain and is smiling when she is offered the change to hold her 3rd great grand child.  Many doctors, social managers, think of the dollar cost and these physical things which is the biggest short coming in my mind for health care today. A much brighter use of this study is that to feel your best, get the best care, you need to interact with people.  That includes staff and other residents.  That is a type of medicine or treatment.  Take a friend out for lunch and you pay.  That might be a better value than the co pay on a pill for depression.   People, friendships, the search for independence are never ending and ongoing up until we die.  Read this article and hear the physical claims but also read betweent the lines to see if you see some of the things I see. They talk about combining eastern and western therapies.  I saw straight social dynamics.  We had them sit in a circle.  Circle to me is very group oriented and social.  Indeed, we do an exercise program at Tender Loivng Care Senior Residence every day in a circle.  Less for the exercise and more for the emotional and social benefit.  What you call it really does not matter but the fact is people need people to feel good.  The physial place matters much less than the people.  A second example is our email program at tlcsr.  We do that more for the family to feel connected than the senior with mild dementia.  Some may say that is a semantic difference but we believe those social sensitivity differences make a big difference in how the entire social system feel and deals with aging now and then their own againg in the future. Second, the author notes"the program focused on creating a "loving, nonjudgmental enviroment to promote postivie feelings and joy" and used music to enhance this effect.  I agree 100%. What I was hearing is find the best caregivers and care team you can.   Look for continuity of care to get the best care, and best value for any private senior care dollars.  Of course, we say repeatedly in this blog Continuity of Care  is the cure to the individual and global health care crisis and that includes Dementia Care, Alzheimer's Care, and Memory care and ALL OTHER DISEASE LABELS YOU HAVE! Quoting Patch adams again.  "If you treat the disease you win or loose but if you treat the person you WIN NO MATTER WHAT THE OUTCOME.!" Really look at the last part of that quote.  No matter what the outcome.  Seniors and all of us know we will die. Dying is not as scarey as being alone, abandonded, and shifted home, place, facility to facilty.  More accurately being shifted from one care team to the next!!  Being shifted away from the main care team, your family you have known for your entire life!  Look for a care team that can and will be able to stick with you, visit you, no matter where you go to get the best value and care possible as you age.  If you accept the sales pitch you did not look far enough.  Take the time to meet the entire care team from Doctor, Administrator, caregivers, med techs.  And ask if they interact with each other.  The more continuity of care in your broad based system the better you will feel and the more value you will get for THE SAME health care dollars. Summary In discussing these variations of interpretation though words and this blog I hope to raise awarness that all people, families, seniors and care teams need to value each other.  Realtionships, caring are a two way street.  Take the time to find the most continuity of care when ever anyone you love is forced by aging to need assistance and choose Dementia Care or any Senior Care Setting.  Not I did not say move. That focuses onthe physical place, instead use this post to focus on the care team and continuity of the people and care. Help us spread the word.  Click for Free Ways to help. It is up to you to make this viral!! Click for The Best, Most Cost Effective, Assisted Living and Senior Care Alternatives By Shawn McGivney

Continuity of Care the Cure for Health Care Crisis!

The article in the NYT's Blog post "After Caregiving, Comfort in having helped" tells a common and I believe already well told story.  Senior Care, cargiving, dementia Care, Assisted Living and health care in general is difficult, expensive and getting worse every day.  AGREED! by Judith Graham. Lets move on to the answer!! CONTINUITY OF CARE IS THE CURE TO THE INDIVIDUAL AND GLOBAL HEALTH CARE CRISIS WE ALL FACE. After Caregiving, Comfort in Having Helped Value people and they will provide many in-kind servcies and levels of compassion and effort you cant buy for dollars. Value your doctor, your family, your friends and their extended soical systema and they will value and help you when you and yours needs it. this cant be legislated but legislation can adjsut the playing field.  We have to act, we the people need to value continuity of care and our doctors.  Many do not know that all doctors get paid the same for an office visit.   Your doctor who knows you, does extra inkind service gets the same as the guy who you dont know who says call anohter specialist.  Second, did you know that specialists get paid much more than your doctor but specialists often say I can't decide on treatment, accept responsiblity for you as a person, that is your doctors job.  Seems unfair to me.  paid less as pcp but expected to do socially the right thing.  I assue you doctors have feelings too.  It is less about the money and more about the value people plance or give to their doctor. Senior Care settings, Assisted Living, Residential Care homes, hospitals  also delegate care.  I for one would be suspect of a place that says I want you to come but the people who work here are not my responsiblity. Do not criticise the current system.  We all have allowed and fueled its growth.  The cure is still right here.  We need to value each other, people, our extended social systems to fix a problem that affects all today indirectly by affecting someone in our own extended social system right now and us tomorrow after an accident or expeceted medical issue, and 5-10 yrs from now when we age ourselves. did you know we all get medicare!!  Yep, if you get hurt right now you get medicare disability.  There is so much you dont know and I cant do it all in one post.  If you invest in me, send comments, I can invest in continuing the discussion. I am sure that the only way to fix the health care system, make it cost effective while still providing a high level of care is to value continuity of care.  Let me know what you think. Help us spread the word.  Click for Free Ways to help. Dr Shawn McGivney  

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