Tag Archives: Residential Care Home

Living and functioning better with arthritis Part 2


Look for devices, equipment and the most family like companion care and residential care when needed.

  Don’t give up on discovering a means to handle your arthritis discomfort. Taking care of a crippling condition can leave you feeling aggravated and desperate – particularly if you are having trouble discovering any treatment choices that work. If what you are doing is not working, speak to your physician about other therapy alternatives or check out alternative treatments such as acupuncture, nutrition or holistic medicine until you find something that assists.

Using makeup as adaptive equipment.

Arthritis can occasionally cause rashes on the arthritic aspects on your body or on your face. If this is the case, you can purchase cover up and other make up to conceal these rashes. Many arthritis victims think that they ought to keep away from makeup, which is not real.  

Medical and adaptive equipment can help with both musculoskeletal pain and function

Obtain devices that are useful. If you have the correct devices you can make it through any task with arthritis. Lots of products exist to assist someone that experiences arthritis do easy jobs, such as special can openers and zipper pulls. Investing in these gadgets can really help you to keep your independence longer, and streamline coping with arthritis.  

Eat well and remain hydrated. Enjoy food and life.

Have a regular eating schedule. Test your body to learn exactly what consuming pattern works finest for you, and established an unique schedule around those times. If you find yourself starving at a time when you are not scheduled to eat, have a light nutritious snack to keep yourself energetic and on schedule.   Handling your arthritis will let you have a life that you can take pleasure in, will certainly less anxiety and pain triggered by your condition. Apply these suggestions to see your arthritis enhance considerably.

Look for special cases like Rheumatoid Arthritis (RA) where there are new medicines to treat it.

Make sure to enlighten yourself as much as possible about rheumatoid arthritis, and how it can affect pregnancy and breastfeeding. There’s a lot of various details out there, and being well informed can make all the distinction on the planet in how you handle your signs and flare ups. Get your vision considered frequently. People who suffer from arthritis are far more likely to have concerns with their eyes also. See to it you care for yourself by seeing an eye doctor a minimum of annual, in order to track any developing concerns that may occur with your condition.    

Consider Residential Care Home as part of your pain and functional treatment as total body aging continues.

When the pain and disability get to great you might consider a supported care setting like an Assisted Living Facility or Residential Care Home. In all cases the care is both physical and emotional and you are wise to meet the entire care team before you pick any companion or care setting.   Links http://www.arthritis.org/ http://en.wikipedia.org/wiki/Arthritis Hospice Care Home Health Care     Thanks for remembering to Like and Share Dr Shawn McGivney    

Trends in Residential Care Homes and Chronic Care

  doctors  Doctor, VIP , Really??   What do misconceptions like this blog post tell us and how can we learn from them? The statement. “Elly’s Doctor sent us a letter recently describing the next step in his practice. He is going to focus on “Wellness”. How much more “wellness” does my Grandma need? This is what flew around in my head! She only goes once a year to this doctor which is the agreement I made with him last summer  :)Smile            So, there is a program called MDVIP that doctors can apply to which helps them reduce their practice. Now that this Primary Care Doctor has been accepted into the VIP Program, he is asking his patients who want to stay with him to pay a $1650 annual Membership fee and it’s first come, first served as there is a limit to how many patients he will accept!”  

My reaction to this comment  is if you have a smile, or smiley face, and only want to see the doctor once a year, or you somehow can think there is nothing else a doctor could do for a 92 yr old even if just to make her smile on a visit then you are probably correct to save your money and go with any doctor or just use the ER doctor when needed.

If you look at the EOB, Estimate of Benefits, from Medicare and the doctor is paid $100 dollars and that covers all of the care until the next yearly visit, all refills, storing the chart, upgrading to the electronic records and any calls, faxes etc in-between you must have missed life 101.  You can’t live or run a business on $100 / year per patient.

I am willing to share many ideas on this topic of choosing a doctor and what is “your doctor” but I want the readers to give us some comments first on these questions?

What do you “need” or want in a pcp?

What makes the doctor “Your Doctor”?   What makes someone your friend, brother, spouse?  At a lower level your accountant, lawyer, or doctor?  Would it be better to have a brother as your lawyer?  How much better can you imagine that might be? Is choosing the insurance really choosing care or the doctor? Are knowledge and skills the only things you need from a doctor or any service provider? What is the value of social connectivity in getting more in-kind services and in adjusting the flexible definition of “needed” more toward your definition and away from the insurance company or government’s definition?  IS CHOOSING THE INSURANCE OR CARE SETTING OR COMPANY LABEL OF ANYTHING IS  GETTING CARE? How can you show you value your doctor and care team? What might a friend, family member, do for you that a stranger would not do?  What could a doctor who was socially more connected to you do for you when interacting on your behalf with the opposition who in this case is the hospital, insurance company or a growingly disjointed health care system? One final thought. What is your life and quality of life worth?  Please comment and start the discussion.  I am ready to continue but need some audience participation to join me.    Here are some educational page links to help you understand the Residential Care Home Choices when faced with caring for an aged parent or family member. OTHER EDUCATIONAL PAGES THAT DISCUSS CONTINUITY OF CARE. http://tlcsr.com/ResidentialCareHomes.html http://tlcsr.com/dementia-care.html http://tlcsr.com/memory-care.html http://tlcsr.com/alzheimers-care.htm   Educational video links TLCSRLV youtube Channel.  Subscribe for free. Assisted Living and Residential Care Home Video Tour.   Assisted Living and Residential Care Home Testimonial    THANKS FOR LIKING AND SHARING  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. value-code-principles 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.


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.value -the-handshake   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 Nursing-home 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?   Change-for-the-better 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  – Education       Educational video links    TLCSRLV youtube Channel.  Subscribe for free.    Frustrated with Home Care Service? Get Home Care answers here!    i-like-button Like, Share!  Thanks for helping!     Dr Shawn McGivney  

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