Family inHome Caregiving Blog
Carmel, CA : Parkinson's Patients Gain Mobility Through Exercise Like Tai Chi
by Richard Kuehn on 02/21/12
People are constantly striving to find anything non-prescription to deal with their physical ailments. I recently had a medical condition that was fairly serious and it was recommended that I go to an acupuncturist. Although skeptical at first, I noticed immediate results. It worked! Now comes news that those suffering from the debilitating Parkinson's disease can improve their health by doing Tai Chi. Strength and stability in the elderly with Parkinson's were shown to improve in a study done by Fuzhong Li of the Oregon Research Institute of 195 people with mild to moderate cases of the disease. Participants attended twice-weekly groups of either Tai Chi or two other kinds of exercise (resistance training and stretching). After six months, those doing Tai Chi fared significantly better in tests of balance, control, walking and other measures. It helped reduce falls as well. The results, published in the New England Journal of Medicine, held after a follow up study three months later. Studies are now being done to see if Tai Chi can help with other diseases like arthritis and fibromyalgia. It's exciting to see research projects like this being done. Although Parkinson's currently has no cure, there are a number of things which can be done to alleviate some of the symptoms. We have become so reliant on prescription medications, that physicians and patients sometimes forget that there might be another answer. Some of our clients take literally dozens of pills each day, which can cause problems with organ function and serious side effects in some cases. Some doctors seem all too eager to add another pill to the pill box when new ailments occur. Hopefully, this study in Parkinson's patients will be the first of many to see how it can help with other health problems that cause mobility issues.
Carmel, CA : Many Seniors Need Hearing Aids, Few Buy Them
by Richard Kuehn on 02/21/12
The Monterey Herald had a story about the unfortunate fact that many of those who are experiencing hearing loss don't wear hearing aids. The reasons are many. Sometimes it's cost and other times it's vanity. And some people are simply in denial about the fact that they are getting older and many things just don't work as well as they did when they were younger. I went through this with my grandmother who didn't start to lose her hearing too badly until she was in her 90's. Part of the problem, believe it or not, was ear wax. Sometimes when we get older the ear wax gets impacted and acts as a barrier to hearing. She could have used a hearing aid as well, but they were just too ugly for her tastes and she never did end up getting one. The Herald story talked about a Johns Hopkins study that found nearly 6.7 million Americans have hearing loss, but only one in seven wears a hearing aid. The study used data from the National Health and Nutritional Examination Survey, a research project which has gathered data from American's dating all the way back to the early 1970's. It's not surprising really. At some point, technology will catch up to this huge problem, and hearing aids will be hidden from view and provided at a low cost. But until this happens, I wouldn't expect a large surge in the number of American's buying hearing aids.
Royal Oaks, CA : Key To Longevity, Healthy Foods & Tabasco Sauce? Story From A Centenarian
by Richard Kuehn on 02/21/12
The Monterey Herald had a touching story yesterday about Alline Robideaux who recently turned 108. She lives here with her 89-year old daughter. Her secret to longevity? She believes it's from eating fresh foods. Her family migrated to California from Louisiana in 1930, suffering through the great depression. She ended up working in a mushroom plant, and always lived a healthy life. Her family moved her from Louisiana and to this day she loves to put Tabasco sauce on her food. Her daughter says, "We go out to dinner every Saturday night. She loves hot wings, hot shrimp, Louisiana hot sauce, jalapenos. Anything highly seasoned." At Family inHome Caregiving, we stress exercise, lots of social interaction and a healthy diet. Although Tabasco sauce isn't something we see many of our senior clients eating, having what you want is important. Many of the elderly lose interest in food as they age, and finding something that will spur their appetite is important. Having family and friends around also increases longevity, I believe. Alline is fortunate to have two living children, and one that lives with her.
Carmel, CA : USA Today Highlights RIN 1235-AA05. This, And AB 889 and SB 411 Could Devastate Seniors Pocketbooks : View From A Private Duty Caregiver
by Richard Kuehn on 02/20/12
It was great to see the Department of Labor's Proposed Rulemaking RIN 1235-AA05 debated in USA Today even though it was a fairly negative story. It said that home health care companies are leading the fight against an Obama administration proposal to require them to pay their workers minimum wage, despite the fact that this industry was one of the few to maintain profits during the worst of the recession. Family inHome Caregiving doesn't do home health, but we would be impacted in a similar manner as the home health industry if this Rulemaking is made official. The ridiculous thing about this article, in my opinion, is that it chastised the home health industry for making a profit during the recession and then went on to say that their profit margin was 2% from 2006-2008 and 4% from 2009-2011. The implication was that these companies could afford to pay workers much more. As anyone who has worked in the business world can attest, a 4% margin is very slim and can quickly evaporate if you lose a couple of big clients. Home health companies and private duty caregiving companies run on very thin margins and can ill afford to absorb more costs. But the article missed the whole point about this legislation. It's not about the profit margins of the companies providing caregivers, it's about the seniors receiving care. Currently, those requiring 24-hour care have two or three caregivers coming in and doing 12, 24 or sometimes up to 3 and 4 day shifts. In order to continue this continuity of care, they would have to pay double their current rate, which few of them could afford. To learn more about this issue, see the series of articles on my blog about the devastating impact RIN 1235-AA05 would have on seniors, doubling the cost of their private duty caregivers for those requiring 24-hour care. At Family inHome Caregiving, we never pay less than minimum wage and in fact pay more than most of our competitors. I'm on my way up to Sacramento now to lobby against two similar bills at the state level, AB 889 and SB 411. Wish me luck if you know anyone trying to help keep a friend or relative that is in their golden years safe and independent in their own home.
Carmel, CA : Open Heart Surgery To Become A Thing Of The Past For Aortic Valve Disease? View From A Private Duty Caregiver
by Richard Kuehn on 02/20/12
A new heart valve developed by Edwards Lifesciences is hitting the market, the first one to be approved by the Food & Drug Administration (FDA) which doesn't require open heart surgery. The launch is a giant leap forward in technology and will likely result in the saving of many lives, particularly those deemed too sick to undergo open heart surgery. About 14,000 people die each year in the U.S from aortic valve disease. Although it's not widely available, there is likely to be quite a bit of demand for the device. However, the manufacturer is being extremely cautious as to which hospitals are able to use the device (dubbed the Sapien heart valve) as it has invested $1 billion and 12 years to bring it to market. It definitely does not want anything to go wrong which could give it a bad reputation. Before it allowed the device to be sold to Robert Wood Johnson University Hospital, for example, Edwards did a thorough inspection of the hospital's facilities. That was a first time a vendor had ever required that, said Mark Rappaport, VP of operations. Although the device avoids the use of bone saws and deep incisions required with open heart surgery, there is a higher risk of stroke and bleeding and serious accidents in the early stages since physicians won't have had any experience with it. Edwards is training the surgeons and cardiologists who will implant it, and will chaperon the hospitals first few procedures. In an unusual move, the company has a sales force of 60 that's paying commission based on the number of successful procedures rather than on volume. The company is hoping to build the business into a $2 billion per year market. The metal, nylon and cow tissue device costs about $30,000, and so far over 25,000 patients worldwide have received them. So far the device is approved only for patients too sick for surgery, just a small portion of the 250,000 Americans who could benefit each year from the treatment, but Edwards is hoping that it will eventually be approved for widespread use. Let's hope the device is a success, open heart surgery is very difficult to recover from.
Serious Questions Arise About Natividad Medical Center After Accreditation Survey By Centers For Medicare And Medicaid : View From A Private Duty Caregiver Serving Carmel, Marina, Monterey, Pacific Grove, Pebble Beach, Salinas, San Juan Bautista & Seaside
by Richard Kuehn on 02/20/12
Salinas Valley Memorial Hospital (SVMH), with their many financial and union woes, has made good fodder for the Monterey Herald for more than a year. But the latest negative story about a hospital on the front page of Thursday's issue of the newspaper was a surprise. The lead was, Natividad Deficiencies Listed In Survey, CEO Urges Staff To Begin Improvements. Recent stories in the Herald had talked about the financial problems at SVMH while Natividad appeared to be the poster child of health. It continued to generate profits despite serving a much greater proportion of Medi-Cal patients than SVMH. The rumor had been that SVMH might merge or otherwise become affiliated with Natividad. That seems up in the air after the results of a validation survey conducted by the federal Centers for Medicare and Medicaid were "not pretty," according to a memo from Natividad CEO Henry Weis to his staff which was leaked to the Monterey Herald. The survey found a number of serious deficiencies and Weis wrote in his memo that the hospital's Medicare and Medicaid reimbursement payments are at stake, "plus our professional reputation!" Natividad receives about $150 million per year from Medicare and Medi-Cal and the loss of these revenue streams would put Monterey County, the owner, under more financial duress. Proper hand hygiene, patient charting, medication security, dosing and administration, dietary needs, buildings and equipment, medical records and patient care orders were all on the list of deficiencies. Quite a list! "I believe we all know it takes a lifetime to build a team and hospital reputation. It only takes a moment to destroy it," wrote Weiss to employees. "Let's focus all our energy on excellence and sustainable change and no energy on concerns about why this happened or was it fair or not," he said. The accreditation survey is a very serious matter and I hope management can move rapidly to get its house in order. It's frightening to have only three major hospitals on the Monterey Peninsula and two of them going through extreme turmoil at the same time. Patients need to feel that they are safe and that employees aren't distracted by union fights with management and other issues like this accreditation survey. I hope that SVMH and Natividad can both resolve their numerous issues quickly.
Carmel, CA : RIN 1235-AA05, AB 889 and SB 411 All Terrible News For Seniors Trying To Remain At Home And Independent
by Richard Kuehn on 02/20/12
I
have been lobbying for some time against a proposed rule change by
the Department of Labor which would harm the frail elderly, impact home care
workers, the businesses that employ them and the government programs that allow
them to age at home. It's been estimated
that private duty caregiving services would have to more than double their
rates to seniors for 24-hour caregivers should the rule pass. The 60 day public comment period was up on
February 17, and I hope the Department of Labor listened to comments posted by
myself and others. The Private Duty Homecare Association of America (PDHCA) and
the National Private Duty Association (NPDA) recently announced the results of
a national survey of home care agencies on the impact of the U.S. Department of
Labor's (DoL) proposed rule which effectively eliminates the companionship
services’ overtime exemption in private pay home care and live-in services. The
survey results demonstrate the negative consequences which would occur for
employed caregivers, the clients/patients they serve, and the home care
companies if the exemption is eliminated.
The greatest negative
impact on clients/patients reported by respondents is the loss of continuity of
care brought on by the need to assign multiple caregivers to control overtime
costs. A common belief is that clients are then driven into the underground
economy, hiring workers "under the table" where quality control and
oversight that an agency worker provides is lost, exposing the elder client to
greater chances of abuse, fraud and inconsistency in care.
The DoL proposal has the
potential to cut employed caregiver hours and compensation by imposing
unaffordable overtime pay on the voluntary hours they work in excess of 40 per
week. In addition to losing continuity of care, the cost for care will also
increase. The survey indicates that 81.8 percent of companies expect to
increase their private pay billing charges with 23.7 percent anticipating a
need to scale back their availability of care. These expectations are warranted
as 45.2 percent of companies currently required to pay overtime under state
laws have increased their charges and 10.4 percent reduced care access.
Shelle Womble, Chairman of
PDHCA commented, "As an industry we believe that eliminating the companionship
exemption will force many seniors and people with disabilities into assisted
living or institutional care because of the increased cost of in-home care. It
will increase federal spending by adding cost to in-home care provided through
federal programs, and by increasing utilization of government-funded
institutional care."
Kevin D. Turner, Executive
Director of NPDA, stated, “One of the consistent findings referenced by
agencies was restricting or expecting to restrict overtime hours for employees.
So, instead of making more money through overtime wages, the average home care
worker will simply work for multiple agencies to get the hours they want to
work in a week. This makes it harder for the home care employee who will have
to match total hours desired with piecing together schedules that will also
include additional expenses for travel to more locations.”
The predominant impact on
the employed caregivers is the restriction in working hours. Nearly 63 percent
of the respondents currently obligated to pay overtime under state law report
that they restrict overtime hours. More than 86 percent of the companies that
will face a new overtime requirement if the proposed rule takes effect report
that they will restrict the hours worked by staff to prevent overtime costs.
Over 93 percent of the
home care companies reported an expectation of a moderate to significant
increase in business costs. This mirrors the actual experiences of companies
with a current overtime requirement where nearly 69 percent report moderate to
significant business cost increases. The primary cost increases are in human
resources, 67.4 percent expected/38.2 percent actual, and staff training costs,
67.9 percent expected/38.3 percent actual.
Some of the potential
tactics and adjustments that companies are or will make as a result of the
ruling, should it be put into place, include cutbacks on employee benefits and
pay increases, withdrawal from Medicaid services, terminating live-in care, and
reduction of current base pay of personal care workers.
The full survey report is
available here http://www.privatedutybenchmarking.com/companionship-exemption-2012.
The survey was conducted
in December 2011 as a joint project between the Private Duty Homecare
Association (PDHCA), an affiliate of the National Association for Home Care
& Hospice (NAHC) and the National Private Duty Association (NPDA). Nearly
1500 responses from home care companies in all 50 states, the District of
Columbia, U.S. Virgin Islands, and Puerto Rico were received.
Stay tuned for more news on this issue. There will be a dramatically negative impact
for seniors, particularly those requiring 24-hour care, should this rule be
implemented. I will be in Sacramento this
week lobbying against similar legislation at the state level (AB 889 and SB
411).
Carmel, CA : Implantable Microchips For Time Released Medications Shows Promise
by Richard Kuehn on 02/19/12
The latest development in the health care realm is implantable
microchips, designed for those with chronic health problems which
require them to give themselves frequent injections. MicroChips Inc. released the results of a
study Thursday which tested a device that's implanted in the abdomen and has a
chip programmed wirelessly to deliver medicine.
Although in its early stages, the device maker says the chip could
deliver medication for at least a year.
The chip could solve the biggest issue of those on an injection
regimen—compliance. Some people forget
to give themselves the injections as needed while others dread having to do it,
and do not do them as frequently as prescribed.
MicroChips Inc. said it will likely take two years to develop a chip
holding 365 reservoirs to hold a year of medication, and then it would have to
do more clinical trials and get regulatory approval. However, the peer-reviewed study which was
published in the journal Science Translational Medicine shows promise. Stay tuned for more developments in this
field.
Carmel, CA : Metal On Metal Hip Replacements In The News Again
by Richard Kuehn on 02/18/12
CarDrug giant Johnson & Johnson is in hot water after it was revealed in today's New York Times that after the Food & Drug Administration (FDA) told the company it couldn't sell two types of artificial hips in the U.S. because they weren't safe, it took them overseas and sold them. The company used a regulatory loophole which didn't require it to have a safety review to sell what are called articular surface replacement devices which J&J's DuPu unit marketed under the name ASR. The all-metal hips were implanted in 93,000 patients worldwide, and had a faulty design. Unfortunately, regulators in Europe are much more lax than the U.S. A spokeswoman for British regulatory agency, the Medicines and Healthcare Products Regulatory Agency, said that companies like J&J were not required to notify it when the F.D.A. refused to approve a product that was used in patients there. The hips were recalled in 2010, and J&J has taken a massive $3 billion charge, much of it related to anticipated legal and medical expenses due to the recall. There are about 4,000 lawsuits involving the device which are now pending. What's sad is that some patients won't recover because tiny particles of metallic debris which were shed by the implants have left them crippled. My grandmother had a hip replacement when she was in her 90's and this can be very dangerous. In fact, the physician told us when she went into surgery that he didn't think she would make it. Thankfully, they were able to do anesthesia from the waist down, and she fully recovered. However, having this type of surgery in the elderly is extremely risky and it saddens me that 10's of thousands of people all over the world will have to suffer through the surgery for a second time due to these faulty devices being on the market.
Castroville, CA Private Duty Companion Aide Or Caregiver Jobs Available (Also Aromas, Gilroy, Gonzales, Greenfield, Hollister, King City, Marina, Monterey, Morgan Hill, Pacific Grove, Pebble Beach, Salinas, Seaside & Soledad
by Richard Kuehn on 02/17/12
Castroville, CA Private Duty Companion Aide Or Caregiver Jobs Available (Also Aromas, Big Sur, Carmel, Castroville, Corral de Tierra, Del Rey Oaks, Gilroy, Gonzales, Greenfield, Hollister, King City, Marina, Monterey, Morgan Hill, Moss Landing, Paicines, Pacific Grove, Pebble Beach, Prunedale, Salinas, San Juan Bautista, Sand City, Seaside, Soledad And Tres Pinos)
I am happy to say that business is booming at Family inHome Caregiving! We have had a greater than anticipated influx of new Clients over the past two weeks, many of which have been referrals from past and current Clients. Our reputation for having the best caregivers in Monterey County is growing.
Family inHome Caregiving of Monterey is seeking compassionate, mature and dependable caregivers (Companion Aides) who want to improve the lives of our elderly Clients by providing in-home, non-medical care, particularly those seeking live-in positions or those who can work 24-hour shifts. Our services include:
· Caring companionship
· Meal preparation
· Incidental transportation
· Running errands
· Light housekeeping
· Medication reminders
· Monitoring of safety while bathing
· Information and referral services
· Other services that improve the safety, security and quality of life of the seniors we serve.
If you believe you would make an exceptional Companion Aide, we would love to hear from you! We prefer those with experience helping the elderly, disabled and others with mobility problems. Having cared for those with dementia and/or Alzheimer's is a plus. To work for us, you must have excellent references, a clear criminal record, a good driving record, and an insured reliable vehicle. To apply, please visit our web site www.fhcofm.com, click on careers where you can fill out an application online. We have immediate openings all over Monterey County. Service areas include :
Aromas, Big Sur, Carmel, Carmel-by-the-sea, Carmel Highlands, Carmel Valley, Castroville, Corral de Tierra, Del Rey Oaks, Gilroy, Gonzales, Greenfield, Hollister, King City, Marina, Monterey, Morgan Hill, Moss Landing, Paicines, Pacific Grove, Pebble Beach, Prunedale, Salinas, San Juan Bautista, Sand City, Seaside, Soledad And Tres Pinos
