Tag Archives: Hospice Care

Assisted Living Improved

Assisted Living Improved

With the adjustment in the economy, the facts of senior treatment additionally change. In future, Assisted Living might have a new face completely, as well as we could witness an adjustment in the housing fads. It might not come as a shock that senior as well as assisted living choices will certainly alter in action to socioeconomic problems. The rise in the expense of assisted living might lead some family members to look for house care and also multi-generational real estate instead of extra pricey treatment alternatives. Those who do choose assisted living will certainly locate a wide range of offerings in brand-new, booming areas like eco-friendly housing as well as supposed “wise residences,” as well as increased services at more standard assisted living communities.
The Decline of the Assisted Living Facility Version of Care
In a city like Las Vegas, where all the high-end is offered, growing number of people have been choosing elderly real estate options, whether it’s independent living, home care or memory treatment. Elements such as the high cost of knowledgeable nursing as well as current cuts to Medicare as well as Medicaid programs have actually sped up the change to individual care services in Las Vegas.
The Increase of Technology-Enhanced Senior Citizen Care
The rising innovation is mosting likely to change senior care. Assisted living in Las Vegas are making use of wise pc systems that keep an eye on drugs and also essential signs to cordless networks that supply mobile support for seniors in care areas. Tus, there are lots of options that guarantee improved wellness as well as quality of life for seniors in such a setting.
More Multigenerational Housing Options
The senior citizens who do not wish to relocate into an area or cannot manage it could have options for an independent way of life. The multigenerational real estate! It is the suggestion that a family will pool their sources as well as either modify their existing the home of fit numerous generations or relocate into a location that’s built to house both young households and older adults.
Assisted Living for the Elderly
Senior co-housing is an additional smart way of getting the most effective of neighborhood living. Co-housing is much more like living in a commune, where old adults live in independent residences but have some shared spaces like yards and entertainment centers to bond with each other. Some also have facilities for common meals and also housekeeping duties. This pattern has been growing over the past years.
Development of Residence Healthcare Industry
More and more elders intend to stay at home for as long as possible. Yet it’s not just enhancements in modern technology as well as civic preparation that are going to assist in aging in place. The growth of home healthcare market is a needed accessory to senior citizens remaining in the house.
Going Environment-friendly
The Environment-friendly Elder real estate offers elders an eco sound area to spend their gold years in tranquility. Eco-friendly building, lighting, and also home appliances not just save cash over time yet likewise are far better for the atmosphere.
Assisted living in Las Vegas is gaining in appeal as well as is seen as future of healthcare. Likewise, several families are choosing personal care solution in Las Vegas for senior.

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

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

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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.


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.


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.



Physical care VS. Emotional Caring In Assisted Living and Senior Care settings in Las Vegas

While all care settings try to differentiate themselves Assisted Living, Home Care, Dementia Care, Alzheimer’s Care, Memory Care, Hospice Care, Residential Care, Elder Care all offer the same thing – CARE!

What varies is the degree of caring you get and feel as both a resident and as a staff member or provider.  Both resident and staff feel better if they know each other and have some kind of a progessional or social relatioship.  That is why continuity of care and having a relationship is so improtant.

Going further physical care could be described as just doing the task like giving a shower.  Caring might be the added small talk about a common event that makes both people share the moment or have a relationship of sorts with the physical care.

In fact there is a significant difference between doing the physical task of giving a shower and then giving a shower combined with a friendly discussion of recent events, recent visitors, or activities both care giver and resident have experienced in the day to day life. That later is emotional health and goes a long way to change physical care inot caring and maximize emotional health for both caregiver and resident. We believe this is a small part of starting to explain the power of relationships, the humanism needed for and involved with in care and caring. This distinction applies to “care” in all care settings Assisted Living, Assisted Living Facilities, Home Care, Hospice Care, Medical Care, Dementia Care, Alzheimer’s Care, Memory Care, Elder Care, Respite Care, Hospital Care, Residential Care, and all of the care settings.

What is “skilled” care vs custodial care. https://www.tlcsr.com/blog/|whitecoat http://tlcsr.com/blog | assistance

Caregiver is a skilled position even if some do not describe it as “less skilled”

Insurance companies constantly try to define custodial care as something less, of lower value, lower price than “skilled” care. In fact, people pay more attention to the caregiver than the insurance defined skilled views of the nurse or doctor. the reason for that is trust and continuity of care. When, not just if, something happens in the day to day life of a frail senior who needs assistance the only skills that will matter are the skills of the person the resident can get and that in general is of the caregiver. The caregivers interpersonal skills, compassion, caring are used every minute of every day to provide feeling good, comfort, redirection and to help empower the senior to remain positive, active, productive and feeling good. That in fact is a skill. Call it patience, compassion, good family values, faith in God, but whatever you call it that is indeed what the senior needs and wants. http://tlcsr.com/blog-caregiver-friend http://tlcsr.com/blog-trust-honesty-comittment Words and ideals we all value highly

Caring is therapy for someone who needs assistance.

What is the “Value” of not getting “care” from the controlling Caregiver? How can a senior who needs assistance really monitor and protect against this? Care Setting and the leadership being hands on, day and and day out, from top levels of ownership down to the caregiver is essential and the only way to provide care with caring? The alternative might meet a physical care need but at what emotional cost.  These images of the controling caregiver are firghting to most seniors. http://tlcsr.com/blog | abuse-man- in-wheelchair Scolding and Control are not caring http://blog.tlcsr.com | Controlling-Staff Controling Staff.

Cost to the Senior of a Controlling Caregiver

Patience, interpersonal skills, and familiarity with dealing with a person who is older and has many complex medical issues that are unlikely to resolve is a skill. Unlike dealing with a child where cure is likely and possible in this case cure and getting younger is much less likely. Seniors know that but no one including the senior will say that. It is ego dystonic, to say you want to die or accept getting old even though we all do it every day. God or a higher being can play a role and does increasingly play a role as we get older and more disabled. As humans we need things to believe in and God and the best interpersonal skills you can find are the first line treatments for all that ales you.

Emotional health and Feeling is the final expression of all disease. 

Patch Adams, in Movie Patch.  If you treat the disease you win or loose but if you treat the person you win no matter what the outcome! No matter what the label Alzheimer’s, Chronic Pain, CHF Congestive Heart Failure, Arthritis the end result will be I don’t feel good. Doctor are trained to look only at the physical part but the many levels of social and emotional therapies are often over looked or discounted. Be it due to physical pain, depression, fear of the future all diseases are expressed the same way. You feel bad. Doctors cant describe it, define it, or study it but we all feel it and can understand it. Indeed, your doctor is uniquely positioned to help you balance cost, effect, side effects, incidental social and implementation and even financial consequences of all the physical and emotional or social choices that are available to you. If you were a doctor you would know the physical stuff and if he were you he would know the social stuff but when both of you have a relationship and know each other continuity of care, caring and the best outcome are possible. That outcome is feeling the best you can given your unique, individual, set of physical, social, and financial illnesses. While many try to be “case managers” including elder law attorney, social workers, nurses in fact there are only two real choices you since you are the most aware of your social and emotional health or how you feel and / or “your doctor”. I use the term “your Doctor” going back to a time when continuity of care was the standard. Hopefully this blog and your examples can help others value people in our lives.

Some People incorrectly under value those who keep the Family, Social System, and Frail safe.  Mothers, Teacher, Doctors Caregivers.

-A mother who works all day to care for the kids and husband and arranges the social system. Not easy, but not values by dollars. -a Teacher who listens, stays after class to help someone who is behind so they are not embarrassed to catch up or get a head. -a care giver who calls and visit when you go to the hospital. or is available to look after your kids and your grandmother because she can it helps the bigger system out. -a doctor or lawyer who goes beyond the standard description to help you understand the system and potential related costs. All of those examples are things that are “not needed”, not valued in dollars, but are often provided to take physical, “less skilled” care to the highest level of care and include caring.

Comment to help others see the value of people in their lives. Help us spread the word. Click for Free Ways to help. Click for The Best, Most Cost Effective, Assisted Living and Senior Care Alternatives Dr Shawn McGivney

Safe Harbor-Lesson in Assisted Living

Mom and Step mom were human.  The X- Wife, Susan Sarandon, was jealous of the younger, new wife, Julia Roberts, but in the end when her breast cancer was progressing, the mom, Susan Sarandon, wanted the best for everyone even her X husband, her kids and her rival the Step Mom, Julia Roberts.   That is the power of people, caring, and relationships.  That power is invaluable and hard to quantify in Dollars.  Look for that and you will get the best value for you Senior Care dollars.

Saw the movie Safe Harbor and wanted to share my Senior Moment http://tlcsr.com/blog-Assisted Living-Happy-seniors The Safe Harbor is another creative way to show that even when one is dead.  The Mother who guided the new wife to help her husband and kids still has value.  I see the similar values to families, society and seniors as they age.  Images of what was, is and can be continue to be powerful influences to families and society.  I know no simple dollar formula for love, hope, trust, feeling needed, wanted, productive and valued.  Likewise defining “safety” is hard for most seniors to swallow since the social worker, family, or individual defining “safety” for the senior often times is focused more on financial, legal, or physical safety than on emotional well-being, continuity of care and relationship building. I see families faced with aging, loss as individuals who are aging and families who are losing large parts of who they are. In losing a senior, but in all cases they want to help each other. Seniors know they are aging and they just want to be known, remembered, and to help if they can.

Feelings are the end point of all process.  Pain hurts less when you are holding your own new born or a grandchild.  The sum of all pains, pills, and Emotional and social therapies including continuity of care and relationship building is part of the treatment.  Complex and powerful therapies, and feelings like hope, trust, belief, faith, belonging, parenthood, creation, choice and empowered to choose, take time and social relationships to achieve.  Seniors and all of us know helping can mean getting others to provide the care so the Family can visit, email and carry on.  Pain and life have large emotional elements that doctors cannot study.  Indeed, few studies add in emotional health and wellbeing since you can’t “study” or quantify it and it varies so much person to person and day to day.  However, that does not mean we don’t value those things.  Indeed, those are the things we buy based on even if we do not know we are. http://tlcsr.com/blog-Assisted-Living-Senor-safehousehttp://tlcsr.com/blog-Assisted Living-change

http://tlcsr.com/blog-Assisted Living-seniors If you want to be “Safe”, have a “Safe Hospital Discharge”, “Safe transition to any Senior Care Setting” look for individuals, people, and care teams with continuity of care.

Sub segmented systems based on business organizational flow sheets and financial payment models pale in comparison to Continuity of Care and Relationship building to make someone feel safe.  To feel safe you have to know and trust the individuals who provide the day to day care and who the problem solves or manager are.  They have to know your social system and visa a versa.  You have to respect what they do and value it also.   Then you can hope to feel safer in a process of transitioning to a senior care setting.

Aging and even dying are not bad they are expected.  What is bad is not having a care setting with caring and a relationship to allow physical care to be transcended to Family-style care we all want.

Two quotes from Patch Adams of the Movie, Patch, that show Caring is more than care.

  1.         Treat the most devastating problem of all indifference or apathy.
  2.        If you treat the disease you win or lose but if you treat the person you win no matter what the outcome.

http://tlcsr.com/blog-Assisted Living Grandkids To me, even if you die, that is not as much of a loss if they had someone who was there, caring, respecting, all that that person has done and continues to do for the family.  That sets a social and family example of valuing people and not just disposing of them which helps each of us in the family, caregivers and all the people surrounding the senior.  I care for my dad and he helps me every day by giving me some space to work.  Yes, he comes in but he then let’s me finish work and that is helping.

http://tlcsr.com/blog-Assisted Living grandparents

Seniors who can find a safe haven or care setting with caring and continuity of care can help their social system and continue to enjoy family life.

Look for Continuity of care in any care setting Assisted Living, Home Care, Hospice Care, Residential Care, Dementia Care, and Alzheimer’s Care, Memory care, Respite Care, Elder Care, Nursing Home Care and any Senior Care setting.  Meet the entire care team and you can find caring with the physical care that all promise you.

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 Shawn McGivney

Family Values, Relationships, and Continuity of Care Affect Value In Senior Care

While assembly line style of care, productivity management, and six sigma standards of efficiency work for inanimate products they are not as good when dealing with a social service like Senior Care. We all need to become more aware of Social and Emotional costs and benefits in choosing a Senior Care setting before we make this expensive choice. Why not get more social and emotional benefit for the same dollar cost that is value.

Life, Social, and Emotional Values  VS Simple Dollar Value When faced with the difficult and expensive task of finding a Senior Care Setting.

http://tlcsr.com/blog-Senior -Care-Family-Values

Choosing a Senior Care Setting for a loved one is a Life Changing event for the entire Multi Generational Family.

Facts about this Family Decision. -Financially Expensive -Socially Expensive. -Emotionally Expensive. -Physically Expensive. YOU ARE BUYING A SERVICE AND NOT JUST GETTING A ROOM.

While most people will see that the cost of $3-6K / mo or$36K – 72K / yr is Financially Expensive most will not initially see the Social and Emotional costs to the senior, the grand-kids of the senior and  the adult children who often helping make the choice of a senior care setting for the senior.

http://tlcsr.com/blog-Senior -Care-Assembly Line http://tlcsr.com/blog-Senior -Care-Controlling Staff

Do not be misled by a Title.  Assisted Living Facility often times is a room and meals with no assistance.  While they do offer assistance from the A La Cart Menu their basic services are more accurately Independent Living, a hotel room and a meal plan.  The services are often more like hotel services of laundry and room cleaning instead of Family Style, continuity of care, based personal care.

No matter what any one or a brochure says the services are, you do not know what they AND WHO IS DOING THEM, until you meet the entire care team including the Administrator and Owner.  Do not forget the Administrator and Owner do run the show even if you do not know them.

How the Family sees you, the Adult son or daughter of the senior, do matter in most social settings.  That leads to emotional feelings for all generations who will often want to do more.  All adult children who are faced with helping a senior make this decision will feel some amounts of  guilt that they can’t do more themselves  with any choices they make.  However, all can feel their best, if they follow one simple rule Meet all of the Direct Care people INCLUDING THE ADMINISTRATOR AND OWNER.

Meeting the entire care team is the only way you can know what services you are getting.  The sales lady can’t describe who is providing the services you are getting.  The tour of the physical plant or building is such a small part of the SERVICES you need and are contracting for.  We believe that many over look the social and emotional costs in favor a quick walk through of the building on a tour.  Without meeting the people who will provide the care on a day to day basis you will not really know what you are getting.


Do not underestimate the value of meeting the administrator and owner.  The management directly affects what the caregiver and medication technicians do day in and day out.

The more hands-on the Administrator and Owner are,  the more likely they are  to value the feelings of the resident,  families and their own staff.   http://tlcsr.com/blog-Senior -Care-Staff-Thumbs-Up It is much harder for any human including managers and owners  to down size, under staff, do less if they make an agreement themselves in person.  When the sales lady promises service she will have no involvement or responsibility for it is likely her promises will mean much less than a promise from the Administrator and Owner who will work side by side with their staff day in and day out.  Indeed, most business people will tell you to maximize profits for the business the managers and owners should not know you or the staff.  Knowing the staff and families  makes it socially harder to under value them.  Of course, our goal is not to maximize profits for the institutions but to show Seniors and Families how to get the most caring they can for their private pay dollars.  http://tlcsr.com/blog-Senior -Care-Handshakes-have-ValueHand Shakes Have Social Value- Look for Hand Shakes not Paper Contracts when Choosing Services. In general, all people work better, are more involved, when they are socially and emotionally appreciated.  That is human nature.  Look for that when choosing a senior care setting and you will get the most care and caring for your private pay dollar. Of course, their will always be some financial reality of who each owner and administrator chooses for their staff but our experience is that more hand-s on the management, the more personally involved the management is with their own staff and the seniors and families they care for that leads to the best value for the Senior and their private pay dollars. When choosing Senior Care in all care settings Assisted Living, Home Care, Hospice Care, Dementia Care, Alzheimer’s Care, Memory Care, Hospice Care,Residential Care be sure to meet and shake hands with the entire care team including the top management.  If you don’t meet they you can’t access their degree of commitment and sincerity to care vs a more financial only, A la Cart, Model of Care. 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 Shawn McGivney

8 Mistakes People make When Choosing and Assisted Living and Comments

8 Mistakes People Make When Choosing Assisted Living and our comments below.

By Shawn McGivney MD, RFA This article from A Place For Mom  is a good general article.  We feel it could be more helpful if it provided a little more detail on how to do the 8 things.  Just saying “don’t over look future needs” or don’t judge a book by its cover, or choose a community to match your parents needs are just not detailed enough. http://tlcsr.com/blog |life values   http://tlcsr.com/blog | care-home-ahead-sign    http://tlcsr.com/blog | assistance This discussion of care applies to all care settings Assisted Living, Home Care, Hospice Care, Dementia Care, Alzheimer’s Care, Memory Care, Residential Care.  Care is a service and you need to understand you are buying the skills of knowledge but also compassion, dedication, caring, which might be even more important skills than hard medical or nursing skills.  Indeed, the social skills are often the therapy for aging, dysphoria, depression, cognitive loss, and promoting people to feel good as they see they need increased levels of care. 8 Mistakes People Make When Choosing Assisted Living http://www.aplaceformom.com/blog/assisted-living-search-top-mistakes-to-avoid-1-22- 13/ We want to share our comments to that with you.

Our comments Great article. I think the details are given better at http://tlcsr.com/blog. You need to meet the management, administrator, and care givers. This article seems to come up short of saying that but that is the only way you can see into the middle chapters of this article. Second, Continuity of Care is not mentioned. Shift work, A La Cart billing tend to promote lack of continuity of care and relationships.


Assembly line hallway Efficient Assembly for physical care Third, we agree with don’t go it alone, don’t judge only by proximity, don’t find a place with an isolated private room because you as a younger, non sick,  persons would choose that, choose for your parents who need assistance and will need even more assistance and remember it is the staff who provide the caring and care now and in the future. Meet the entire care giving team including the management! We find superficial discussions like this are too general to be really be helpfull and can be misleading if you don’t get these details.  When faced with a social and financial decision of this magnitude take the time to meet everyone involved in the care starting at the top. The management does impact  the care the staff provide. Socially, you can be respected for finding the most cost effective and best care and set the example for your entire social system. You can save money when compared to the usual course of a bait and switch type A La Cart system where they get you in for the room and meals AND NO, OR MINIMAL CARE OR ASSISTANCE, and then rasise the price to 4, 5, 6K when, not if, you need care.  24K / yr at 2K a month or 48-72 K a year at prices with minimal assistance are worth spending the time to meet the entire care team. Do not think you can or will get the same level or amount of caring you most likely expect unless you meet the entire care team. The management may define care as included in the contract DIFFERENTLY than you do.  For example, how many have found out after they bought the insurance that the “support” they purchased had indeed be re sold many times and now was bundled into who knows what, giving you some phone care from another country? Hands on management _ Do not accept management on paper, long distance calls to the corporate office as the main level of management.  This is a service and you need to meet, shake hands, and know the direct care managers.  If the Aide is the only person you meet and know like in home care then she is the de facto manager, owner, and aide but know that is who and what you are getting.  You are most likely still the manager and highest level skill person on your team.  You did not add any skilled people, advice, or a back up care team you added an aide and often times at a high dollar cost.  Home care is a great option but be sure to consider who the day to day manager is since that is part of your care team. To get these smiles you need to know the entire care giving team. People, Pets and Flowers Can provide Smiles and Caring to go with your Physical Care.


This is a service industry and you need to meet the entire care giving team from top to bottom to really start to compare what you are getting for your 24 – 72K a year.

Take the time to learn all you can you will be socially viewed in the best light and your parents will get the best care and best value for their health care dollars.


By Shawn McGivney