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DEMENTIA CARE: LAS VEGAS DEMENTIA CARE COSTS PROJECTED TO RISE!

 Dementia Care Costs will be reflected in the cost of Dementia Care in Las Vegas too.  I wanted to share this NYT article “Dementia Care Cost Is Projected To Double by 2040” by +Pam Belluck. This article is a good description of the aggregate dollar costs spent on Dementia Care and only begins to touch on the spiritual, social, and family costs of Dementia Care.  Unless we can improve the Dementia Care that is available to families so that families feel that the care teams are invested in caring for a member of their family team as an extended family many families will still choose to do the Dementia Care at home. By having Dementia Care Homes, or Dementia Care Facilities, that offer more family style care families can feel good about the care their loved one is receiving.  Now there is a dementia care shortage of Residential Care Homes that offer this type of care.  The more institutional settings of a big Assisted Living Memory Care Unit often are just too big for the administration and staff to know each resident and their families well. Another New Old Age Blog Article helps us see what to do. Studies Find Mixed Results for Dementia Units http://newoldage.blogs.nytimes.com/2013/05/10/dementia-care-units-may-improve-care-studies-suggest/ You need to know who you are getting to know what you are getting in Dementia Care or any Senior care Service. Meet and know both the caregivers and the administration to get the best Dementia Care and value. Mean Caregiver Or Nice Caregiver?   The article implies that while big Assisted Living and Institutional Dementia Care units try to improve their image with unique names you need to look beyond the name to meet the care givers and administration who you are hiring.  We note that the above article is correct, Dementia Care is expensive, but we also note that to get the best care and value you need to know who you are getting to provide that Dementia Care in a Residential Care Home, Home Care or Dementia Care unit. Here are example of names Dementia Care Units adopt from this article --The Memory Care unit, The Reminiscence Neighborhood, Homestead.  Read the full article Studies Find Mixed Results for Dementia Units. They go on to say “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. To complicate things further, many Assisted Living Facilities have specialized units for dementia, too.” That is the point we want to expand on to save you money and get you better social, emotional, and spiritual value for your private pay Dementia Care dollars.  Precisely because there is little standardization the care teams vary widely.  Indeed, you can’t know what you are getting when getting any service until you know who you are getting.  That is our message to meet and know the direct care team including caregivers and administrator and managers. Two common mistakes to avoid when looking for Dementia Care in any care setting. We know that all senior care is a service and has two parts both of which are important - the custodial care and the administration and management.  The two mistakes are to classify custodial care as unskilled when in fact it is a very skilled job.  The second mistake is not to assume the management are able or available to deal with problems and emergencies and  are interacting day to day with their care team that you are hiring. Custodial care is in fact a very skilled service even if some mistakenly label it as unskilled or less skilled. The custodial, day to day, care which arguable provides the “quality of life” can be seen when you look at the in-kind feelings and experiences there ideas reflect  “the day to day I care”, the attitude of “I will sit with you, let’s talk about your daughter and grandkids” and the many conversations that could occur while doing the day to day personal care.  Beyond the important emotional health issues  there is more skilled care dealing with obtaining, faxing, recording, giving, and following up on the medications, the doctors’ order, and dealing with insurance and medical problems when they arise. Care Givers are skilled and families need to understand that all caregivers are not the same.  The article quote above says there is little standardization which means beyond some very basic training of 8 hrs the training comes from the administration and care team itself.  Families need to understand that caregiving is very difficult for themselves and has devastating results on their own multi-generational  families and that finding substitutes to provide complex, very difficult, emotionally rewarding care requires each family meet the entire care team they are hiring for to help their loved one and entire extended family for the last chapter of life of one of their own family team members.  Caregivers are often mistakenly classified as Less Skilled or unskilled when in fact they provide the direct care, they implement all the doctors’ orders, and they are the eyes and ears of the doctors who make decisions based on what the care givers see, understand, and do.  Care givers are very skilled people.  Because they have good social skills, are smart and able to learn the many complex tasks required to do medical related care they can easily move on and do something easier.  If you and the administration don’t treat them fairly they will move on since they are very skilled.  If you have staff turnover you are likely getting less skilled workers as is often the case in Assisted Living and Home Care.  The administration is investing less in all that extra training and paying for those with the outstanding social skills.   Even if there were standardizations we know that when it comes to caring, social connectedness, diligence, work ethic in any profession even professions with high amounts of standardization like becoming a doctor, lawyer, or politician there is a wide range of “skills” and “values”.  In all cases you need to meet the entire care team of care givers and administrators. Many say the caregivers are “less skilled” or “unskilled” in fact the behavioral treatments that provide most of the care and feeling good in dementia care come from the highly skilled caregivers who provide not only the custodial care but who understand, communicate, and implement all of the doctors’ orders.  Remember these caregivers understand the orders given by the internal medicine doctor, the psych doctor, the cardiologist, the urologist and many other doctors and the families all at once.  That takes a knowledgeable person who knows the medical terms, equipment and diseases and who has impeccable social skills, patience, and mother like skills to understand, implement and monitor all of those things for the many doctors who write the orders.  Caring for people with cognitive disorders and who not kids are is a very different emotional task than caring for kids where the parent or caregiver is the presumed responsible party.  It is the parent’s way or highway works in child care but in Dementia Care that is not the case.  The senior with mild cognitive loss generally has some mild paranoia and has at least some unrealistic expectations and it is the caregivers who have to adjust which is not an easy task .  Indeed, it is even harder for families to adjust because they were and still are “the kids” in the eyes of the cognitively impaired parents.  The son or daughter’s  job of reestablishing themselves as the parent when a senior has even mild loss of insight and judgment and paranoia will be very difficult.  That is why you need to look for the best care team of caregivers and administrative staff to get the best Dementia Care in any care setting including Assisted Living, Assisted Living Memory Care, Residential Care, and Residential Care with Dementia endorsement, Home Care, Hospice Care and Elder Care in general. Mistake #2 - The Administrator and managers need to be available and directly connected to the care givers they are supervising. Many families make the mistake of assuming that the administrator and management will be available with little notice to deal with the expected problems and emergencies that occur in complex medical and custodial dementia care.  Families need to know the skilled people, administrators and managers are available and able to deal with medical related problems when they occur.  The administrator also needs to be available to their own staff and the residents on a day to day basis to work directly with and train the skilled care giver staff.  One simple test is to see if the administrator or managers are available to come down and talk to you on a tour when you want or are there for your tour?  If not they might also not be available to deal with the emergencies when they occur also. You don’t think about who is training the caregivers to do that complex skilled work noted above and who will intervene when the problems with medications, insurance, and the doctor arise?   That is generally the role of the administrator or manager and they need to be in close contact with the patients doctor and they also need to be able to understand what the doctor is saying and not saying which is not an easy task.  A two line note often does not consider what was considered in the process of getting to the two line note.   However, if the management has some medical experience it is more realistic that they can interpret the doctor’s notes and orders.   The care givers need constant feedback and assistance to get questions answered on a daily basis from a skilled person generally with medical experience so they can learn.  If a caregiver is working on the floor but never sees that skilled person, never or rarely interacts with the doctor or nurse at the bed side, it is unrealistic that they can know the many degrees of shortness of breath, what wheezing is, or leg edema is.  On the psych side knowing what delusions are and bizarre behaviors are requires not only the administrators bedside training but also you need to know that individual and need to be able to ask your coworkers if this has been going on for days or hours.  If you don’t have that team approach seeing subtle changes is next to impossible.  In dementia care like no other care setting team work of administrator and staff is of paramount importance. Check out these fantastic Residential Care alternatives to the Assisted Living and Nursing Home Rehab.  Compare Family -Style care of a Residential Care Home to Nursing home and Assisted Living which are more institutional care models. Residential care, Assisted Living, and Nursing Homes all offer custodial care but what varies is the care team you choose when you choose any care setting.  Who is doing the day to day training, supervision, and support of a hands-on management and who is doing the custodial care?   Look for the care team to get the best Assisted Living, Residential Care, Home Care, Retirement Community, Hospice Care, Dementia Care, Alzheimer’s Care and Memory Care in any care setting.  Look beyond the setting label and find out who you are getting before you buy. Tender Loving Care Senior Residence - Or Tender Loving Care Senior Residential Care, Costa Brava  - Educational video links TLCSRLV youtube Channel.  Subscribe for free.  Alzheimer's Care, Las Vegas: Find the best Alzheimer care home in Las Vegas. IF YOU ENJOYED THIS POST – LIKE AND SHARE IT. Dr Shawn McGivney

Value your Residential Care Home or Assisted Living care team as treatment for chronic disease.

Value your Residential Care Home or Assisted Living care team as treatment for chronic disease. Lifestyle is great preventative medicine. If you already have chronic disease Lifestyle alone is much less effective at reversing or making it better. is an interesting article and I imagine Dr Katz book “Disease Proof”  is interesting too.  I just want to comment that for those who are already older, who already have chronic disease, there is less lifestyle can do and more medicine can do.  When I say medicine I include emotional health and the value of relationships with those around you, your doctor and the care team who will be with you in this difficult last chapter of life.  Even if the care team does nothing they are your access to whatever choice you make and if you trust them, your certainty of your choices, will be higher which will mean you are more at peace with what every you choose. “Lifestyle as Medicine: At a Fork in the Road, Who’s Got a Spoon?” While great works like the JAMA article from 1993 Actual causes of death in the United States.   show how lifestyle affects our lives and death rates this is too simple an analysis.  Just like all medical studies have a control group to remove the “difficult to study” aspects of being human like: variations in income, social situations, culture, preferences, and the need to survive emotionally in this society, limit what medical studies can do.    I would argue that the single most practical approach is to work with a care team that can grow with you and provide medical, social, and emotional assistance in this last chapter of life.  Instead of focusing on what doctors can’t do, what studies don’t show, what might be if we did not like food,  I prefer to think of balance, working with the family and extended social system as a more flexible and practical plan in which you win no matter what the outcome.  Of course, we all want to live forever but that too has many meanings depending on who is staying it and where they are in life.  If you invest in those around you, your friends, family and care team you will age as well as possible given your unique circumstances. My favorite quote forms the movie Patch.  “If you treat the disease you win or lose but if you treat the person you win no matter what the outcome”.  That last phrase “no matter what the outcome” is where emotional health, feelings, and being part of the care team even in that last chapter of life are the treatment.   If you are tossed to another care team or a hospice care team and you never meet the doctor and you are changing care givers every few days it is likely that does not create as good a feeling of safety, being needed or wanted, as staying with a care team and doctor who have known you for decades.  Feelings and relationships do matter in life but we all need to invest in them especially when any member of our extended family or our team develops a chronic illness.  Yes, just getting old is a group of chronic illnesses and we all will get there some day, some way, no matter what we eat. [caption id="attachment_1527" align="alignleft" width="167"] http://tlcsr.com/blog-dementia-care[/caption] When any young, Lifestyle treated, person gets older they too will get some chronic diseases and they too will need help even if it is later in their life.  Then they too will need a medical care team that works with their friends, family and social system to balance hard medical treatments, pills and medical testing with the great therapy that are people, relationships and the interpersonal skills of the extended care team they choose including the medical and custodial care teams. Check out these fantastic Residential Care alternatives to the Assisted Living and Nursing Home Rehab.  Compare Family -Style care of a Residential Care Home to Nursing home and Assisted living which are more institutional care models. Residential care, Assisted Living, and Nursing Homes all offer custodial care but varies is the care team you choose when you choose any care setting.  Who is doing the day to day training, supervision, and support of a hands-on management and who is doing the custodial care?   Look for the care team to get the best Assisted Living, Residential Care, Home Care, Retirement Community, Hospice Care, Dementia Care, Alzheimer’s Care and Memory Care in any care setting.  Look beyond the setting label and find out who you are getting before you buy. Tender Loving Care Senior Residence - Or Tender Loving Care Senior Residence, Costa Brava  - Educational video links TLCSRLV youtube Channel.  Subscribe for free. Frustrated with Home Care Service? Get Home Care answers here!    Happy Holidays!  IF YOU ENJOYED THIS POST – LIKE AND SHARE IT. Thanks for the Like and Share Dr Shawn McGivney    

New Assisted Living and presumably Residential Care Home Screening tool.

Just saw this new Assisted Living and Residential Care Home screening/rating tool and wanted to share it with you.  In general, the more tools you can read the more and more focused questions you can ask when you meet the entire care team you are hiring including the administrators, manages, and direct care teams. While this is a great resource it is important to note that it focuses on tangible items more than on the feelings and emotions that result in care.   We realize feelings, dedication, hand-on management vs delegated management are hard to “study” in a survey but we believe those are what care, senior care and assisted living are all about in the last chapter of life.  Beyond their self imposed certification one might ask to see the data of the facilities and questions they used to arrive at that conclusion to get a more transparent and useful picture of the process they followed. How Do Las Vegas Families Evaluate Assisted Living Options for mom and Dad? From what we can tell and they divulge they base their reviews on Inspection data, ratings from local experts and reviews from residents and their families which then turned into an internal rating.  It would be nice to see more transparency of the weights, values and quantification of each item in their scale and the ones that they elected not to consider to better know how they arrived at the rating. Other things to consider or inquire if they considered. Of course we don’t know if the top rated places are subscribers to a related service are influenced by an advertising package on their site http://www.seniorhomes.com/ as is commonly the case in most forms of advertising.  We also don’t know what other care options they considered like home care, private case managers, residential care homes, smaller group or residential care homes or if they just looked at Assisted living facilities.  Did they use the definition of “Assisted Living” used by the state of Nevada or their own definition of Assisted Living?  Any of these “resources” are just that a small part of the picture that you can use when you visit each place and start to meet and know the administration and staff you are hiring to provide the Assisted Living, physical and emotional care.  It really is who is doing the work and management more than the care setting label, the referral source recommendation,  that should be your focus. We don’t know the administrator to resident ratio.  The administrator is the captain of the ship and a captain who supervises a bigger crew will likely have less contact with the staff to share their expertise.  While delegated management works in less personal care it is not as good when people, human emotion and feelings are involved.  Relationships require interpersonal time. We concede that it is very difficult for any “study” to begin to accurately access the interaction of management with their own care teams.  A good analogy of the role of the administrator would be the quarterback of a football team.  If the quarterback praises the line and the defense the team is generally stronger.  The same is true in Senior Care and Assisted Living.  Coordination of the care team both manages and direct care staff is essential to providing the most care and caring possible.  You can see how the managers interact with and value their staff when you meet them and take a tour with them and that is time well spent to get the more care for your private pay dollars. [caption id="attachment_1277" align="alignleft" width="167"] trust-care-caring[/caption] Tlcsr Free Care setting Search Tool. In all cases ratings and resources like the senior home .com  one and the TLCSR Free Care Setting Search Tool https://www.tlcsr.com/free-care-setting-search-tool/   are great tools to help all seniors and families.  Unlike the senior housing.com tool the tlcsr tool helps you uncover more information about the care you will need and then who is providing the care now and when problems, changes in your medical needs, or other social and financial/insurance issues arise.  Using both tools/ratings as guides to the questions you ask the direct caregivers and management staff will help you to know who you are getting beyond the very basic, less quantified, advertising on the brochure of “We care”. Value the handshake and meeting the individuals on your team over the advertising and paper contract.   Senior Care and Assisted Living are expensive. We believe following our plan of meeting the managers and care team will help you feel socially and emotionally how much and who cares and save you money.  It is up to each senior and family to know who they are getting before they spend $30,000-$50,000 per year for care.  Make time to meet the entire care team and use these tools as a guide for the questions to ask.  What you are looking for is not the yes / no answer, or check in the box, but you are looking for the passion, dedication, and interaction of the administrator with their own team and residents while they answer your questions on the tour.  Relationships are about the process and passion and go way beyond yes/ no answers or checks in a column on any free care setting search too. Most of all, everyone needs to understand the senior care is a service and you need to meet the entire care team in all cases to compare the care, caring and sense of dedication to each resident and their own staff that is felt in any care setting.  These tools just help you remember to ask basic questions.  What you are looking for is the passion, dedication, availability of the management to meet you before you move in to start to get an idea of who will be managing and then providing the direct care you are buying now and for the last chapter of life of your loved on.  The people you are hiring matter.  Take the time to meet them and if they are too busy to meet you then you need to consider that before you decide to move in. Check out these fantastic Residential Care alternatives to the Assisted Living and Nursing Home Rehab.  Compare Family -Style care of a Residential Care Home to Nursing home and Assisted living which are more institutional care models. Residential care, Assisted Living, and Nursing Homes all offer custodial care but varies is the care team you choose when you choose any care setting.  Who is doing the day to day training, supervision, and support of a hands-on management and who is doing the custodial care?   Look for the care team to get the best Assisted Living, Residential Care, Home Care, Retirement Community, Hospice Care, Dementia Care, Alzheimer’s Care and Memory Care in any care setting.  Look beyond the setting label and find out who you are getting before you buy. Tender Loving Care Senior Residence - Or Tender Loving Care Senior Residence, Costa Brava  - Educational video links TLCSRLV youtube Channel.  Subscribe for free. Frustrated with Home Care Service? Get Home Care answers here!    IF YOU ENJOYED THIS POST – LIKE AND SHARE IT.   Dr Shawn McGivney    

Las Vegas Getting New Nursing Home and Assisted Living Facility with its own shopping mall on the first floor.

 My first thoughts when reading this article were that would be great for families who could enjoy the mall and entertainment of the Las Vegas strip while visiting their loved one but then I thought the frail seniors might not get the same benefit if the families spent most of their time shopping and less of their time with the seniors.  While this is an exciting project I just wonder if the exciting mall and casio’s will at some level lead to less family and personal contact with the seniors who are in these Assisted Living and Nursing Home beds?  There is no easy answer and we need choices in Senior Care.  If the mall on the first floor is not for you there are many choices in Senior Care including ones that offer a family style of care instead of the business model of care with the mall on the first floor. Secondly, in all cases people provide the care in any care setting and you need to meet the individuals in the care team to know who you are getting. Advertising is just not detailed enough to begin to know who you are getting as the managers and caregivers and what relationships you can hope to develop in this last chapter of life. Public subsidy to bring skilled nursing, assisted living center downtown Here is the full Article Public subsidy to bring skilled nursing, assisted living center downtown Las Vegas strip just upgraded with a new high end, 150 bed nursing home, 140 Assisted Living Beds, and a new first floor mall.  This should help the many wealthy gamblers have a place to put mom close to the strip so there is easy access to the local entertainment for the family. Will this help the poor long term care patients or is this targeted for the private pay nursing home and assisted living crowed and possibly the short term rehab that medicare pays so well for?   The article did not say if they would take Long term stay Medicaid  patients as opposed to private pay nursing home patients,  or what percentage of long stay, long term care, Medicaid patients they expected to care for in the facility.  The article implies that they will offer physical, occupational and speech therapy among other rehabilitation.  They did not clarify if that mean this will be preferentially for short term rehab only or mainly which in general are the high pay Medicare days and not for the low pay, long term, days Medicaid traditionally pays for.  That will be interesting to find out when we all learn more about how this will impact the long term care for the frail seniors of Nevada. I know this distinction of Medicaid long term days and short term Medicare rehab days will be new form many but it is something you will quickly learn when any loved one starts to need assistance.  Also this is a distinction many find after they have spent down all of their savings and now get medicaid.  How medicaid and medicare work together is something you should discuss with your doctor who in effect uses these resources for you or on your behalf for you.   Here is the direct quote from the lvrj “Saltzman said the skilled nursing center will be six or seven stories, with about 150 beds, and offer physical, occupational and speech therapy among other rehabilitation. The assisted living center will be eight stories, with about 140 units, and the parking garage will be five or six stories with 464 spaces, he said.” This should be good from the sales space addition in that we will get more mall sales jobs and for the Assisted living and Nursing home sections we will get more jobs for those places.  We are happy that the investors could get that discount from 5-11 million which was the quoted value of the land in the article for 3.5 million for 3.3 acres in down two Las Vegas.  I hope the other tax revenues they note will pan out as well for Nevadans. For those looking for new care alternatives that focus on the care and family style care we suggest you check out these care alternatives. Fantastic alternatives to the Assisted Living and Nursing Home Rehab.  This is a family style care option to compare to more of the same nursing home rehab and Assisted Living.  If you look at the staff, staffing systems instead of the mall on the first floor the care you get are likely to be different. These care settings offer custodial care but with day to day training, supervision, and support of a hands-on management with decades of medical and custodial care experience. Look for the care team to get the best Assisted Living, Residential Care, Home Care, Retirement Community, Hospice Care, Dementia Care, Alzheimer’s Care and Memory Care in any care setting.  Look beyond the setting label and find out who you are getting before you buy. Tender Loving Care Senior Residence - Or Tender Loving Care Senior Residence, Costa Brava  -        Educational video links    TLCSRLV youtube Channel.  Subscribe for free.    Frustrated with Home Care Service? Get Home Care answers here!    Like, Share!  Thanks for helping!     Dr Shawn McGivney  

What is Home Care, Home Health Care, In-home care, skilled care and unskilled custodial care?

What is Home Care, Home Health Care, In-home care, skilled care and unskilled custodial care? "Home care" is a simple phrase that has varied meanings for different people.  Generally, there are two types of Home Care Services- 1)- Home Health Care services – which are services provided by a licensed professional, like a nurse (RN), Physical ( PT) or Occupational therapist (OT) , Speech therapist (ST) or a doctor (MD). They make physical assessments and provide specific treatments and teaching as directed by your doctor. This is generally covered by Medicare but is on a short term basis and has to focus on one skilled need and not for the day to day care man y need and want.  Medicare generally pays for this for an episode that last about 6 weeks or 10 visits and then needs to be reevaluated.  While Skilled Home Health Care is paid for by Medicare on a short term basis, the custodial care, or Day to day care,  is usually not paid by insurances and is private pay. 2)-  Home Care services- which are provided by personal care assistants, Certified Nurse Aides (cna), Home Health Aides ( HHA) or caregivers.  They provide custodial care or assistance with Activities of Daily Living (ADL’s) like dressing, bathing, cooking, cleaning etc..   While cna’s, hha’s, and caregivers have many labels to describe custodial care givers the training is similar and is very simple and basic.  The main training is to make sure caregivers of all labels are screened for criminal records and are free of contagious disease.  The training or licensing is met by a quick care doctor’s employee physical  and TB screen.  That is the general training required by the state or the agency hiring them.  As in most jobs the more advanced and targeted training comes after they are hired from the institution you choose.  That owner, administrator, doctor or supervisor of those caregivers is the one who will be training, adjusting the training, and modifying the training to meet the individual patients needs. In fact, care giving is a highly skilled job and requires advanced social skills, patience, a personality of a caregiver like a mother, medical skills and familiarity with medications and the process to obtain, administer and monitor their effects, and use DME (Durable Medical Equipment) in the process of carrying out the doctors and skilled nurse’s orders.  Even more important is that this training is ongoing by the doctor, administrator, managers of the agency who is supervising the home care workers to ensure the training is individualized and adjusts as the residents care needs change.  We caution all to look more closely at whom you are getting as a caregiver and who you are getting to fill that role as the caregiver’s supervisor, trainer, and manager when choosing any care setting. Costs of custodial home care. Custodial home care is generally private pay and is not covered by Medicare or Medicaid.  Medicaid does have some waiver programs but these are not the standard and require that you are poor and have Medicaid. For most people these services of home care and personal care are private pay.  The Medical, Short term, Skilled Nursing, Home Health care noted above is short term  and only supplements the family care or privately paid custodial home care services. While many will say why isn't custodial home care covered by insurance, the answer is a practical one.  If it were covered all would want live in, 24/7, day to day help for custodial care, housework, shopping, or a personal maid and caretaker.  Of course, that is a job for families and is not generally available. Ways to get the Best, Most Cost Effective, Home care. In fact, the custodial care team you choose, administrator, supervisor, and manager and direct care staff, will provide, execute, and be a big part of the medical treatment and execution of that treatment your doctors orders.  Taking the time to find the best care team will be the most important part of your plan to save money, reduce redundant and disjointed care, and get the best value for your private pay senior care dollars.  If you think of any service team you can understand that while the coach or doctor makes suggestions it is up to the direct care team to execute that plan.  Also it is up to the players in the trenches to tell the coach that they are getting beat on the rush by the other side so that the coach can adjust and double team that opponents player who is beating his player.  As we know admitting you need help or are getting beat is difficult and we believe that is a skill that the care team system develops by developing trust among and between the administrator, manager and caregivers or in this example coach and his players. What we can do is to take the time to meet the care team that we do hire in any care setting to assist us when our loved ones start to need a little assistance.  Meet the entire care team including the owner and administrator who will train, direct, manage the care no matter what setting the care is provided in including Assisted Living, Residential Care Home, Home Care, Hospice Care, Retirement Communities, Dementia Care, Alzheimer’s Care, and Memory Care.  If you have not met the owner, administrator and caregivers you do not know who you are getting. We need your feedback.  Like, Share, Comment to continue the discussion.     Check out these alternatives to Home Care and Home Health Care.  These care settings offer custodial care but with day to day training, supervision, and support of a hands-on management with decades of medical and custodial care experience. Look for the care team to get the best Assisted Living, Residential Care, Home Care, Retirement Community, Hospice Care, Dementia Care, Alzheimer’s Care and Memory Care in any care setting.  Look beyond the setting label and find out who you are getting before you buy. Tender Loving Care Senior Residence - Or Tender Loving Care Senior Residence, Costa Brava  - Educational video links TLCSRLV youtube Chanel.  Subscibe for free . Frustrated with Home Care Service? Get Home Care answers here!    Dr Shawn McGivney  

Las Vegas Hospice Service: Learn about the most cost effective hospice.-blog post.

Las Vegas Hospice Service: Learn about the most cost effective hospice.-blog post. I just saw a must watch video. Click this link for video:  Learn about the most cost effective hospice   LEARN MORE BY CLICKING THE "SHOW MORE" BUTTON BELOW THE VIDEO. Click the youtube url link above. Then look for and click the "show more" tab in the section under. That will bring up the rest of the description that reveals pre screened comments. OTHER HOME CARE AND HOSPICE LINKS HERE NATIONAL CANCER INSTITUTE HOSPICE CARE FACT SHEET: http://1.usa.gov/cCtWoe GREAT HOSPICE RESOURCE PAGE: http://tlcsr.com/hospice-care.htm I CARE, COMMITMENT, SERVICE REQUIRE RELATIONSHIPS, TRUST, AND SOCIAL INTERACTION IN ANY SERVICE ARENA INCLUDING SPORTS TEAMS, THE MILITARY, FAMILIES, BUSINESS, LAW AND IN HEALTH AND SENIOR CARE! individual team members are needed for special skills sets on or in any team or organization but it is the team that endures over the long run. When you hear stay at home remember to look more broadly for the care team with the both skills, passion, and commitment to provide the physical and emotional care you want, need and expect to need in this last chapter of life. VALUE THE FEELINGS OF THE CARE TEAM AND THEY WILL MOST LIKELY VALUE YOUR FEELINGS TOO ! Care and caring require knowing each other for the human element of caring to take hold, meet the care team you select for this final journey in the last chapter of life for a loved one and your entire extended family who will be impacted by this choice. We believe seniors and their extended social systems sometimes focus on the more tangible building when choosing an Assisted Living or Senior Care setting instead of focusing on the care team who will do the direct work and solve problems. The care team, administrator and direct care givers, are the ones who can are the ones who will improve your emotional health. Often times people fear moving to a new place not because of the place but because of the loss of control they expect. They often times feel abandoned and fear the unknown of who they will have to interact with. Unfortunately these fears are often true. We all have heard of the nursing home where the nurse says stay in your chair, or the group home that says it is time for bed at 6pm, and many other examples where the staff do over use. What we believe seniors and their family are looking for is that cohesive Senior Care Team of administrator and direct caregivers that allow the senior as much control as possible over the remaining things they can control and a care team that empowers the senior to do as much as possible for themselves even if doing so takes the staff longer. For example,when the staff allows the senior to walk to the bathroom to change a wet brief instead of changing it in bed they improve the emotional care and empower the senior to feel more in control of their bodies. Of course, they get more exercise and interaction with the staff also. There is no doubt the care team varies widely. However, we believe all will be rewarded with improved care and more in-kind services by making time to meet the entire care team. WE BELIEVE THAT YOU NEED TO MEET THE ADMINISTRATOR, MANAGERS, DOCTORS AND CAREGIVERS TO KNOW WHO YOU ARE GETTING. Knowing the management is essential since they set in general on the amount of staff. The owner and administrator also decide how much additional training and education the management provide to the caregivers. Many would be shocked at the minimum required training for most professions and it is the same for caregivers. Few seek out the the new sophomore college quarterback, instead they look for a team leader who is interested and able to work side by side with their team and to train them to be even better every day on or off the health care battelfield. In fact, an administrator is your point guard when it comes to coordinating the staff in the senior care setting. Then they have to describe those new medical or care suggestions to the family and their own teams, and finally assist in implementing the providers or other parties suggestions. That is what we view as the duties of a care team leader and is what we think you need to look for in any care setting you inquire about. That individual could be nurse. We strongly recommend making sure that responsible party is on site and is active day to day with all of the care team including the resident and the residents family. If the leaders do not know the first names of each staff member it is likely that there will be missed opportunities for staff and manager to share small but needed details that could improve physical and emotional health. When you meet the leader who introduces his/her entire care team by name you can start to feel the difference between physical care and continuity of care or more complete care that includes attention to a seniors emotional health needs. HERE ARE TWO EXAMPLES OF CARE SETTINGS WITH STRONG LEADERSHIP ARE SHOWN BELOW: Tender Loving Care Senior Residence And Tender Loving Care Senior Residence, Costa Brava.   Visit to get an idea of what you might be looking for in all care settings when you face this expensive and difficult experience in the last chapter of life for one in your own social system. WE HOPE WE HAVE OFFERED YOU SOME NEW THOUGHTS TO HELP YOU GET NEW IDEAS IN THIS LAST CHAPTER OF LIFE OF A FRIEND AND LOVED ONE: 1-BE SURE TO LIKE THE VIDEO ON YOUTUBE WHEN YOU CLICK THE LINK ABOVE AND WATCH IT. LIKE BUTTON IS ON THE TOP JUST BELOW THE VIDEO. 2-THANK YOU IN ADVANCE FOR SHARING THIS POST BELOW. SEE SHARE LINKS FOR FB, G+, TW BELOW. DR Shawn McGivney.

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