Elder Caregiver Blog in Sierra Vista, Arizona

February and March Events

2012-01-17T18:50:00.000-07:00

There are four local expositions in February and March, 2012.

Cochise College Nursing and Allied Health Career Day, Friday, February 17, 2012, 11:00 am to 2:00 pm. In the Student Union Building on the Sierra Vista Campus. Contact Cochise College for more information.

Health Fair 2012, Saturday, February 25, 2012, 10:00 am to 3:00 pm, in The Mall At Sierra Vista. Contact The Mall or the Chamber of Commerce for more information.

Senior Expo 2012, Saturday, February 25, 2012, 10:00 am to 1:30 pm, in the Ethel Berger Center, Sierra Vista, Arizona. Contact the Ethel Berger Center for more information.

Sierra VistAbility Day, Saturday, March 31, 2012, in the Buena High School Cafeteria. Contact the City of Sierra Vista for more information.

Fame or Notoriety?

2011-12-30T14:51:00.000-07:00

A city policeman entered the office to face three of us at once. Which person to talk to? We were all too helpful, and a choice had to be made. He came to my desk.

Someone had stolen a purse at a convenience store. A fuzzy image was caught on the security camera, witnesses gave a description and mentioned that she might be a caregiver. Was she one of our caregivers? I was sure she was not; we are quite picky about who we hire. But we went over the description; no one like that was working for us.

He said that our company was the first that came to mind. He did not know many home care companies, and did I know of any others? I gave him a list, since they are not all in the yellow pages, and very few of them advertise. No wonder that he thought of us first. Top of Mind is exactly what we want.

On his way out the door, he noticed our caregiver pictures posted on the bulletin board and looked them over. I hadn't thought of that. I had posted the pictures so caregivers could easily recognize each other, since they were seldom all together. They did make good "mug shots."

Should I be wicked and point out the bulleten board to applicants, telling them that the police like to take a look once in a while? A little pre-screen test to see their reactions?

Vanity Care

2011-12-27T11:55:00.000-07:00

(Sometimes you inherit an employee you would never hire.)

She did not like real work. She was completely charming during conversation. If an elderly woman needed some company or transportation, she was your person. But if someone wanted housekeeping, it had better be very light work. She kept asking for easy assignments and seemed to think we could pull the perfect client out of a hat. But we had few easy clients.

She often cancelled unwanted assignments on short notice, claiming some kind of family emergency or car trouble. We could almost predict when she would cancel, and tried to have back up ready. By this time, we were just strategizing until she left.

Once she claimed that her car had a dead battery so she would not be able to work the next day. I decided to call her bluff. I told her I would pick her up at home and take her to her assignment and home again. She agreed; there was not anything else she could do!

She was vain about her good looks. One day she telephoned to say that she had lost her ID badge, but she could bring in a photo to use for her new badge. When she arrived with the photo, we were amused to find it was a glamour shot. We made her a new badge; no real harm done, and it made her feel better.

One dear elderly lady with temporary overnight care, told her other caregivers about a problem with Lucy (not her real name). Lucy got up so early to get ready for her day, that the client could not sleep well. The client did not want to tell us because Lucy kept saying she needed the money (something caregivers should never say). The caregivers did not like what they were hearing and told us about it.

I decided to catch Lucy in the act. I arrived at the assisted living facility early the next morning and stood outside the client's door. Sure enough, Lucy walked out that door with her heavy makeup perfect, her hair perfect, her clothes perfect. That was the last time she spent the night with a client.

I am glad I can say that I did not hire this person. I inherited this employee when I bought this business. There were a few employees that I was glad to see go.

(The first of possibly many confessions of a cat herder.)
http://www.youtube.com/watch?v=ryMgZ0pyGS4&feature=results_video&playnext=1&list=PLE996F5C7C1CB287D

Home Repairs and Elder Care: The Amateurs and The Pros

2011-12-06T10:58:00.001-07:00

I can make plumbing repairs, patch a roof, finish sheet rock, install an electrical breaker, and more. I learned all that while "just a housewife." I like the independence of doing it myself.

But I would not want to re-roof my entire house, or try to nail a full-size piece of sheetrock on my own. Some jobs are just too big, and I would never get them done properly alone. I also would not be able to do my usual work, which can not go undone.

For those big jobs I need a professional.

When a person first begins to need home care, family and friends can pitch in to help. A little time here and there is no big deal. But when the duties require more skill and more time with no end in sight, it is time to call in the pro's.

That is where we come in.

We have the skills and the quantity of people needed to provide much of the extra care. As a family member who cared for a terminally ill relative, I know just how badly that extra help is needed. It is not good for the family caregiver to go it alone. One can keep both one's sanity and one's health, if one has some help.

Is your ill relative reluctant to allow anyone to provide his personal care? If you do not mind providing the personal care, you can hire someone else to do the cooking and housekeeping for you.

But is your relative demanding that no one be allowed in the home? I am sorry, but you need to put your foot down. Be blunt. Make it clear that your health is failing as a result of having no time to take care of yourself. Point out that if you have to go into the hospital, your relative will have to accept another caregiver or enter a nursing home. Lay it on the line, give him or her a short time to mull this over, but make it clear that you are getting extra help.

Refuse to be a doormat. No one else will take care of you if you do not take care of yourself.

The Personal Character of the Caregiver, Part V

2011-11-25T17:06:00.001-07:00

Ongoing Quality Control

There are various ways that we monitor quality of service. Sometimes when a client likes his caregiver he will not tell us that a caregiver is arriving late; but our remote time clock will tell us. Sometimes, rarely now, I have to be the substitute caregiver. Many clients have never seen me, so I go in as if I am just another caregiver. Clients will tell another caregiver things they won't tell the office staff. Also, other caregivers will report if a caregiver is not doing his or her job thoroughly; they do not like having to do someone else's job as well as their own.

Our care coordinator visits with the clients periodically and not only asks if the caregivers are satisfactory, but looks for signs of anything left undone. In the office, we talk with clients and family members by phone, and ask if they like their caregivers, or if there are any tasks that need to be completed or corrected. We take client input seriously. If a client wants a different caregiver, we will accommodate that request.

On the other hand, if the caregiver is uncomfortable with a client and requests reassignment, we will accommodate that request as well. Part of quality control is making sure that employees are happy with their assignments. (See the previous post.)

On the bright side, most clients become very attached to their regular caregivers and vice versa. As one dear elder lady said just last week, "Martha is the only one I trust. I don't have anybody else near me to help, and Martha is so kind."

So, should you let that stranger into your home? After all this process, I would say, "Yes!"

(This is the last of a five-part series.)

The Personal Character of the Caregiver, Part IV

2011-11-18T10:06:00.001-07:00

Fostering Caregiver Success and Satisfaction

We have learned that increased training immediately after hire greatly reduces employee problems. The new employees learn what to expect from us and what we expect from them. They are given the tools they need to do their jobs, and are encouraged to ask lots of questions. We have a policy manual and documentation processes to go over, and care classes. The increase in initial training has made a big difference in how well a caregiver starts out.

But sometimes, after all this, a new hire will start calling off work on short notice. It can be because the caregiver has a valid series of family emergencies, but that is rare. And we can tell. How do we handle this? First we provide a substitute caregiver if the client is agreeable to this.

If a caregiver calls off an assignment more than once with spurious excuses, we will take that client assignment away from the caregiver permanently. The caregiver with fewer and fewer assignments soon learns that calling off is not acceptable. The same with tardiness.

On the other hand, we need to provide our caregivers with the tools and the environment to succeed. We may have hired a potentially excellent caregiver who needs a little guidance. Young women in particular, are afraid to bring up any problems they have with an assignment. We have to encourage them to tell us what is really the problem. Don't call in sick, just tell us that the client is being ill-tempered towards you. Don't say you forgot a medical appointment, just tell us that your car is bottoming out on that rough mountain road. It is simple, just tell us! We cannot solve a problem that we do not know about.

Sometimes resolving a problem involves further training. At other times, the caregiver needs a different client.

Caregivers, by nature, are sensitive people. They feel for others and want to help them. But they also are sensitive to negative comments made by others. A caregiver can be deeply hurt by an unkind and unwarranted remark by a client. Most caregivers are very forgiving, knowing that no one can be cheerful all the time, and that people who are not feeling well are unlikely to realize how irritable they sound. But some clients have sadly developed a habit of criticizing every caregiver. The caregivers quickly burn out with such clients and have to be rotated to other clients. If they were not rotated, they would have no choice but to resign.

A kind word from one client can help a caregiver get through the rest of his or her week with less cheerful clients. Wouldn't it be wonderful if more clients had the ability to say one kind word a minimum of once a week? Sadly, the troubles of aging often cause people to be very demanding.

This blog post, Elderly Caregivers Unkown Plight, talks about how the elderly can verbally and emotionally abuse their family caregivers. Much of this applies to hired caregivers as well. It is the biggest reason that caregivers either resign or ask to be reassigned to a different client.

Hint: Be nice to your caregivers, they are doing their best to help you.

(This is part four of a five-part series.)

The Personal Character of the Caregiver, Part III

2011-11-02T16:49:00.000-07:00

The Interview and Background Screens

The applicant shows up for the interview. The time of arrival is noted. Appearance is noted if it is out of the ordinary; that can be either good or bad. We have a number of questions to ask, that help reveal more about the person's knowledge and skills; but we also pay attention to facial expressions, tone of voice, and other clues to attitude and character.

My personal method is to listen sympathetically, which causes the interviewee to open up and reveal more than intended or even realized. Looking like a sweet, gray-haired grandma has its advantages.

I once listened to a young woman who appeared to be very caring toward the elderly. But as I listened, she seemed to care about the elder person only when she was with the elder. When the client was out of sight, the client's needs seemed to be so completely out of mind that the caregiver had no qualms about calling off work on short notice.

I sensed during the conversation that this particular interviewee did only what felt good. When with the client, it felt good to help the client. When something else offered a bigger feel-good opportunity, that took priority over the client. The young person was simply motivated by what felt good, without any traits of reliability, consideration, or even understanding what was the right thing to do.

First Tip: The problem behavior or attitude the interviewer notices, is something the applicant has trouble controlling even during his or her best behavior. That problem is going to be much worse once that person is hired.

Second Tip: First impressions are important. I quickly learned that my first impression of an interviewee is correct. Since I had spent most of my years as a stay-at-home mom, I was not sure I had the experience needed to quickly assess a person's character. I soon learned that I had that basic ability, but I needed to hone that skill with more experience.

I tend to assess people as being better than they are, so I know to correct my inner scale.

If I think a person is:                That person will be:

a poor choice                           a dissappointment
                                              (I assume this, of course!)

a neutral choice                       barely adequate or mediocre
                                              (I now avoid the neutral as a result.)

a good choice                          adequate

a great choice                          good to great

I hire only the good or great on my inner scale, since I know there will be problems with anything less.

What about a charmer; someone who knows how to make a great impression? I am aware that charm can be used by a person of any character, and that most people of good character do not have or need a high level of charm. I may consider a person's charm when thinking about which clients need that quality. More importantly, I want people who can show genuine kindness. That kindness may be revealed differently in different personalities.

After the interview we will mull over the conversation, and talk to other people in the office who interacted with the applicant. If anyone picked up on something, good or bad, we want to gather all the information possible.

So the interview goes well; the applicant appears to have good character and good knowledge. The background screens and references can still pick up on problems. Since we are working with vulnerable adults, we pay close attention to the screens. We use more than one screen because what one misses, the other finds.

How does that fit with my inner scale? We can all be fooled for at least a short time. But after so many years, I am harder to fool. Also people may well learn some hard lessons and change for the better over the years, but the background screen may not have enough years to show a clean record.

We have a zero tolerance requirement for problems that show up on criminal screens. However, legally, those screens can reveal only so many past years for most types of crime.

If the criminal screens are clear, the motor vehicle report and employment references are good, then the caregiver is hired, oriented, and assigned where he or she is needed and where his or her personality is most likely to succeed.

(This is part three of a five-part series.)

The Personal Character of the Caregiver, Part II

2011-10-28T13:23:00.000-07:00

The Application Screen

For a variety of reasons, something like sixty percent of our applications do not even pass a thorough read.Many of the applications we receive are from people of good character, but they do not have the skills needed, or do not have any idea what this type of work involves.

Our experience has shown that most people with no clue about this type of work will not stay. An inexperienced person needs to be eased into the work, but we do not always have clients with easy tasks for the uninitiated.

If an application passes the read, it is placed in the "yes" file. When we have a need, we look in the file, go through the applications to find the people with the specific set of skills needed at that time, and set up interviews.

Surprisingly, a number of people will not show up for the interview. Their applications are noted with an interview no-show and placed in the "no" file.

A few applicants will call to reschedule the interview two or three times, then fail to show. On the second request to reschedule, I suspect this person may be unreliable. So I already have a bad impression before the interview even starts. If a person repeatedly cannot keep an appointment for a job interview, that person is not going to meet job assignments.

Those who have passed through these filters and show up for their interviews do not realize how much they have succeeded to get this far.

(This is part two of a five-part series.)

The Personal Character of the Caregiver, Part I

2011-10-26T10:22:00.000-07:00

The Reputation Screen

Almost everyone is afraid to let a complete stranger come into his or her home to provide care and have the run of the house. One wants to know, "Is this person trustworthy, reliable, compassionate, and competent?"

Before that stranger enters, a senior person wants to know if the home care business that hired the caregiver is first trustworthy, reliable, compassionate, and competent. Such a business is likely to have caregivers with the same qualities.

The question is, what level of these qualities is required by each home care business? For example, does the home care company tolerate a large amount of tardiness or does the office staff allow only a few tardy arrivals before the caregiver's employment is terminated?

Obviously the quality of the caregivers is a reflection of what the business owner believes to be important. I have reluctantly referred potential clients to other agencies because I did not have enough high quality staff to provide immediate service for that person.

I could have claimed to have the staff and hired less than optimal caregivers just to get another client. But that would have backfired badly. The client would have been dissappointed with the poor quality of care and would have told others about the poor service. In the long run, my business reputation and consequently, my business revenue would suffer.

People rightly place a good deal of faith in the recommendations of their friends, which is why the reputation is so important to protect with good business practices.

But how does the office staff screen out the poor qualities and find the caregiver treasures? Some of that is just experience. After thousands of applications and hundreds of interviews over the past ten years, there is nothing major that gets past us. There is always a clue about anything serious.

Part of it is the quality of character of the interviewer. Someone of good character will hire someone of good character, having no tolerance for poor quality of attitude or behavior.

(This is the first of a five-part series.)

Our Tenth Anniversary - Help Us Celebrate!

2011-10-17T15:12:00.000-07:00

You are invited to our open house, this Wednesday, October 19, 2011, from 9 am to 5 pm. We will have delicious food, free drawings every hour, two grand prize drawings at the end of the day, and good company.

Our grand prizes are a digital photo frame and a George Foreman grill. Our hourly prize drawings are gift certificates or gift cards for Ace Hardware, Hastings, My Big Fat Greek Restaurant, La Casita, and Cafe O Le, The German Cafe on Paseo San Luis, and The Country House Restaurant. You do not have to be present to win, just be present to enter the drawings.

Please come, we would love to see you!

The Sierra Vista Herald article.

Communication: Are We Perceiving The Same Thing?

2011-08-16T17:13:00.000-07:00

Communication can be a tricky business under the best of conditions. But we all have varying perceptions, attitudes, and backgrounds. Sometimes I wonder how we manage to communicate at all.

For one thing, many people would not be aware that synesthetes may have emotional reactions to certain methods of communication. Check out this article, http://news.bbc.co.uk/2/hi/8248589.stm.

My form of synesthesia is labeled Ordinal Linguistic Personification. For me all the ordinal numbers have personality and gender. Briefly, 5 is an assertive girl, jealous of 6 and in love with 7. 6 is a sweet but passive girl, also in love with 7. Now 7 is a handsome male, sometimes in love with 6, but darned if he does not carelessly allow himself to get into situations with other cute little numbers! Well, I can live with it if he falls in love with 2 in an equation, but it is better if he is paired with 6. Then there is 9. He is just plain sneaky. He will use other numbers to get what he wants, and he wants to steal 6 away from 7. 6 + 3 = NOOOOOOOO!

Now how was I supposed to do math properly if I had an emotional reason to want the equation to cause 7 to pair with 6 and not 5? I would start thinking of ways to fix the problem so 6 can return to 7 like she should. The problem was, there was not enough class time to solve the relationship problems as well as the mathematical problems.

Many people with this phenomenon are quite good at math. Not me. There was entirely too much story telling involved. It was hard to keep my mind on task if I was overly concerned with these flighty little numbers that refused to settle down to monogamy. I wanted the good numbers to be happy and win, and the bad numbers to lose. But the little critters didn't know what was good for them.

My poor teachers (and my Mother!) never knew what they were up against.

Now it is just an amusing curiosity. But it is a good thing I never told my teachers in the 1960's! I was prone to imagination anyway and I thought this was just more of it.

I have mostly ignored these little numeric personalities since I left grade school. I can hardly be worrying about whether 6 and 7 are going to solve their relationship problems by the other side of the equal sign when I am trying to figure which can of tuna is the cheapest.

But what if I get Alzheimer's and end up in room 69? Will I react? 67 is a good match, but not 69. Bad 9! Will I yell at 9? Will I beat him? Oh, yes, I think I can drive my keepers crazy. Communication will have to be very creative to get to the bottom of this problem.

Post-Evacuation Results For Elderly

2011-07-08T11:46:00.000-07:00

Although they all returned home, our elderly clients have been affected by the wildfire evacuation. One was home about three days when he was admitted to the hospital for a few days with pneumonia. Another has been admitted permanently to a nursing facility; another needs more hours of care at home.

A few with dementia were confused, fearful, and in turmoil during the evacuation; sundowners was worse. Most seem to be getting back to their usual routine now, thankfully.

An Update On The Fire

2011-06-26T18:34:00.000-07:00

Sunday, June 19, 2011. Driving west on Charleston Road.
Sunday, the smoke could be seen from Tombstone.

I am glad to report that none of our clients and caregivers lost their homes in this fire. I am so sorry for the people who did lose their homes.

Evacuations were hard on our clients who had dementia. One gentleman thought the billowing smoke was thunderclouds. He was expecting rain and could not comprehend the need to leave home to get away from the fire.

Another client kept everyone up and awake in the friend’s home that she and her neighbors had evacuated to. She fretted about her house, her cats, and her birds. Yet another client with dementia is fearful and more confused than usual.

The one remaining evacuation area was opened up for residents to return barely two days ago. One of our clients was able to go home just yesterday. Another client returned home in Hereford to find that dust and ash had come inside her house through the vents. Because of her health issues, she will not be able to stay home until the mess is cleaned up.

Our caregivers returned to their homes on different days throughout last week as areas were taken off the evacuation list. One caregiver who had been sent to a shelter in Douglas, fifty miles away, was among the last to return. They were all glad to get home.

The fire seems to be over for Sierra Vista and Hereford, at least. Fort Huachuca is still a little too close to the fire for comfort, so it’s not over yet.

Quite a number of people have suffered a disruption of their lives, but are grateful to have a home to return to. Others have lost their homes, but are grateful they did not lose loved ones. Sadly, a number of pets have been lost, and people are looking for their furry companions.

The city’s web page lists a number of resources. Information about the county/state assistance center for people with losses not covered by insurance can be found on this page. Information about donation needs can also be found there.

The Facebook page, Monument fire az, was shut down suddenly when the admins had a family emergency. Another page, Monument Fire AZ has started up. There are still lost pets to be found, and needs to be met. You can find some of them on this page.

This fire has made us realize that we need to be more prepared for evacuations. I think I want to mark a box of inflatable mattresses in the garage, and have that ready to go with my tent and camping equipment, just for starters.

And we need to have more information collected on where our clients plan to evacuate, and who will help them. The information we had was adequate for this situation, but things could have been much worse.


Smoke billows south of Sierra Vista last Sunday.

All in all, most of us feel very blessed to be home and out of harm’s way. And we haven't forgotten that people are still working hard to put out this fire.

The Monument Fire: Caregiving During Evacuation

2011-06-18T14:34:00.000-07:00


Fire climbs up Miller Peak. View from our office.

First a big thanks to the fire crews, the city and county personnel, the volunteers, the lodging places, ranches, pet boarders, nursing homes, assisted living homes, the hospital, and so many people who are helping with this fire and the problems it has caused.

Our part is very small indeed. We have merely made sure our elderly and disabled clients continue to receive services during and after evacuation. We did have to prioritize. Someone who needed housekeeping can wait a few days so someone who needs more personal care receives it.

Fortunately, the evacuations did not come all at once. We monitored the radio, the very useful Facebook page Monument fire az, the Wundermap, the city and county pages, Fort Huachuca's Facebook page, apb online for a fire personnel radio feed, and the Sierra Vista Herald which posted updates to the evacuation map that proved very helpful. Many of these web sites and pages shared useful links to get information about the fire, and posted information as it came in. That continues as of this writing.

Facebook as a disaster relief communications center? Really? Well, yes, that is what happened. I did check Twitter for #monumentfire, but I did not find that nearly as helpful. It should be kept in mind that in other kinds of disasters the internet might not be functional.

First we tracked our clients and caregivers homes on our scheduling system's map and printed it out. So, thanks to Appointmate for that useful feature. Then we highlighted evacuation and pre-evacuation zones as well as road closures on those maps.

With maps in hand, we started calling clients and caregivers in the pre-evacuation and evacuation areas to warn them. Some had heard, some had not. We asked if they needed help should they have to leave. We asked where they would go, made sure we had telephone numbers for their destinations. We called family members of clients who could come get their relatives when necessary.

One of our very disabled clients was with our caregiver when the evacuation order was given suddenly. This was when the fire jumped Highway 92 and was traveling quickly towards homes in the area. It was a dramatic, if minor, evacuation, leaving everyone a little frazzled, but safe. This client is staying in the hospital for now, and his wife is staying at a hotel.

The caregiver involved had to evacuate her home later. With the worries about her client, her house; and her husband working all night with emergency services on post, she did not sleep that night and cancelled work the next morning. We re-scheduled her clients. Caregivers who could, stepped up and took on extra work for caregivers who had to be evacuated.

One client needed a prescription delivered to him in Palominas. A caregiver drove the back roads to get around the closures and deliver his meds. She tried to talk him into leaving, but he was determined to stay put.

Yesterday, that caregiver had to evacuate her own home when a fire broke out on Fort Huachuca near her neighborhood. Thankfully, that fire was brought under control quickly and she was able to return home the same day. A few clients in that area also returned home in the evening.

One of our caregivers is staying in the shelter at Apache Middle School, but still working! I am sure it is more pleasant to spend several hours in a client's home, than to sit in the school facilities with many other people. All the same, she could be moaning her lot and asking for help. Instead, she's helping others.

The grey-haired disaster relief brigade? Don't underestimate little old ladies! We have caregivers in their 70's and early 80's who are working through this! We have men and women of all ages who are doing a great job.

Telephone calls continued each day as we listened to worried employees and clients, wondering if they will have homes to return to. We re-assigned caregivers as needed, and updated them on where their clients were staying. Esther, our office manager and scheduler, has taken the brunt of the phone calls and scheduling tasks. It was getting emotional, as she put it, listening to everyone's worries.


Smoke from both the Monument Fire and the Antelope Fire.

So far, so good, we have kept track of clients as they moved to shelters, and some moved back home. No one has lost essential care services. It is now Saturday, the fire seems to be lessening, but that can change. We can all pray for less eventfulness. But at least we are all getting our jobs done!

Local Veterans Benefits Counselors

2011-06-10T13:25:00.000-07:00

The Arizona Departmet of Veteran Services provides a network of Veterans Benefits Counselors (VBC's) who provide information and assistance to veterans, and their dependents and survivors, in matters pertaining to federal and state benefits earned by honorable service in the armed forces of the United States.

Veterans Benefits Counselors assist you to:

Process VA compensation and pension applications
Appeal VA decisions
File for survivor benefits
Apply for aid and attendance and housebound benefits
Request military service records
Obtain information about state benefits

Southeast Arizona Veterans Benefits Counselors:

All offices are open Monday - Friday, 8 am to 5 pm.

Tucson Main Office
5232 E. Pima Street, Suite B
Tucson, AZ 85712
520-207-4960

Davis Monthan Air Force Base

Retired Activities Office
3500 S. Craycroft Bldg #3210
DMAFB, AZ 85707
520-228-5825

Sierra Vista
1300 Buffalo Soldier Trail
Sierra Vista, AZ 85635
520-458-7144

Safford

624 S. 5th Avenue
Safford, AZ 85546
928-428-3403

In general, if you are already receiving home care (such as our services), you can take documentation of home care expenses to your Veterans Benefits Counselor and apply for the VA Pension with Aid and Attendance. The benefit provides some financial assistance to continue paying for services or products.

For more information, call one of the VBC offices above, or go to
The U.S. Dept. of Veterans Affairs: Pensions
The Arizona Dept. of Veterans' Services

Local Sources for Bedside Commodes, Toilet Risers, Walkers, Home Medical Equipment

2011-05-27T16:27:00.000-07:00

The following are local stores that carry Home Medical Equipment such as toilet seat risers, bedside commodes, and walkers for the elderly and disabled. Pharmacies, grocery stores, discount department stores, and medical supply stores have various types of equipment in stock, or available to order. If you know of other local sources, please feel free to post them here.

Medicare may reimburse the cost of equipment, if your physician writes a script.

The durable medical supply stores may deliver the equipment if you cannot easily get out of your home.

Sources in Sierra Vista:

Advantage Medical & Oxygen Supply
2270 E. Fry Blvd. Ste. E4
Sierra Vista
520-458-7330

Preferred Homecare
999 E Fry Blvd
Sierra Vista
520-459-1725

Apria Healthcare
2377 E. Fry Blvd.
Sierra Vista, AZ
520-452-1382

The Scooter Store
Scooters, power chairs
Sierra Vista, AZ 85613
866-790-0713

The Scooter Store worked with one of our clients to get her a power chair through Medicare. Other suppliers had not been as helpful to her, but this is The Scooter Store's specialty.

Sierra Medical Supply is unfortunately closing it doors soon. They are a part of Sierra Vista Regional Health Center. Medicare and AHCCCS rate cuts have resulted in Sierra Medical Supply getting cut out of the hospital budget.

Our old office space was near their store. We bought our supplies of masks there, we ocassionally rented a Hoyer Lift or wheelchair from them, and they were good to loan us a used oxygen tank for caregiver training at times. They were always friendly and helpful.

CVS Pharmacy
2090 E. Fry Blvd. (The Safeway Plaza)
Sierra Vista, AZ
520-458-1254
Walkers, toilet seat risers, bed rails, walker parts, quite a range of the smaller equipment.

Walgreens
1950 E. Fry Blvd.
Sierra Vista, AZ
Walgreens has toilet seat risers and many other small assistive devices.

WalMart
500 N Highway 90 Bypass
Sierra Vista, AZ
There are some supplies in stock, but you can order online as well.

Bashas/Food City
85 S Highway 92
Sierra Vista, AZ
The pharmacy department has a few supplies.

K-Mart
2011 E. Fry Blvd.
Sierra Vista, AZ
The pharmacy department has a few supplies.

Fry's Foods and Pharmacy
4351 East Highway 90
Sierra Vista, AZ
520-458-0997
The pharmacy department has a few supplies.

Thrift Stores
Used equipment is often available at the second hand stores in town.

If The Caregiver Has A Medical Emergency

2011-05-14T07:46:00.000-07:00

What Happens To The Person In His Care?

How will emergency personnel know that someone is in the house with a need for care?

Smart Card For First Responders

A Smart Card is a universal form, placed on the refrigerator in your home or the glove box of your car. It provides critical information to First Responders concerning an individual with special needs. The Smart Card explains the special needs of the indiviuals in your home so they know what physical or mental challenges they need to be aware of.

First Responders are Police officers, Firefighters, Emergency Medical Technicians, Paramedics, Ambulance Personnel, and any other personnel associated with an emergency responce.

How does the Smart Card work?

Imagine that you've called 911 because you are experiencing a heart attack. The dispatcher will notify the First Responder that there is a call coming from a home that is registered with the Smart Card Program. Upon arrival, the First Responders will assess the situation and then check the refrigerator for the Smart Card. If you are unable to speak, the Smart Card will explain to them abou the special needs of others in the home. It helps the First Responder know how to better recognize and respond to the needs of the individuals with special needs (which includes individuals with developmental disabilities and/or mental illness).

Special Needs:

Physical, mental, emotional, behavioral, learning, developmental, cognitive, and medical needs.

Examples:

Autism, Traumatic Brain Injury, Cerebral Palsy, Developmental Disability, Epilepsy, Serious Mental Illness, Mental Retardation, Down Syndrome, and Seizure Disorder.

To Answer Your Questions:

Officer Tracy Grady, 520-452-7500, Sierra Vista Police Department, E-mail: tracy.grady@sierravistaaz.gov

Capt. Bob Fields, 520-417-4400, Sierra Vista Fire Department

Engineer Sam Loucks, 520-417-4400, Sierra Vista Fire Department

Sierra Vista Police Department
911 N. Coronado Dr.
Sierra Vista, AZ 85635
Tel: 520-452-7500

This information was copied from the Sierra Vista Police Department's Smart Card brochure.

The next question this brings up is, what arrangements have you made for your loved one's care if you should have an extended stay in the hospital?

New Drug Old Drug

2011-04-12T10:15:00.000-07:00

Image via Wikipedia

I read an article, a few months past, that touted a drug that could be used to stop menstrual bleeding for several months at a time, with a once or twice a year menstrual event. This was said to be a good thing, because it mimicks what happens during pregnancy – no menses for nine months, then bleeding for a time after childbirth.

To get women on board with this idea, the convenience of fewer periods was emphasized. But to get women to accept the idea of an occasional heavy period, and to get them over the idea that this drug might be harmful, mild scare tactics were used. The writer said that monthly menses were not the normal state of things before birth control became possible. Women were constantly pregnant and had fewer menses. So ladies let's all take this drug to avoid the dire consequences of monthly periods that women have been having since pre-history.

My thought at the time was that we should leave nature alone, and these new birth control drugs are very likely harmful. There have been plenty of new drugs that have been shown to have sloppy data about their safety and usefulness. I no longer trust the drug companies or the FDA to screen drugs for safety.

I just picked up a book in the library, White Coat Black Hat by Carl Elliott, about the spin-doctoring and biased test data the pharmaceutical companies provide. It is eye opening.

In the first chapter I came across a story of a birth control drug that worked great but caused occasional severe menstrual bleeding. The pharmaceutical company wanted a writer to put a positive spin on the bleeding. She refused, and for whatever reason, the company did not market this drug. I do not know if this is the same drug and the same company, but I find the idea appalling.

Apparently, making money off of women who do not want to get pregnant is not enough. The drug maker wants to make money off of all women by informing them of a false need they never knew they had, and then providing a drug to solve yet another female problem.

So what does this have to do with aging? Plenty – the elderly often are taking too many different drugs as it is.

The next time you see an advertisement for a new drug, or your doctor gives you samples of something new, be wary. Do some research of your own, or ask for an older drug with a proven track record. It's your health that is at stake.

Client Satisfaction Survey

2011-03-22T10:24:00.000-07:00

The results for the October 2010 Client Satisfaction Survey are in, and once again, they are very, very positive and reflect that Comfort Keepers franchisees are doing a fine job of caring for their clients. 95% of clients would recommend Comfort Keepers.

Our franchisor conducts these surveys twice a year. Nationally, 3000 surveys were mailed to randomly selected clients. 32% of the surveys were returned.

Four surveys were returned from clients that we serve locally. All four were very positive. The notes that our clients wrote were:

"(The office is) very pleasant on phone and reliable"

"Reliable"

"We are so grateful and appreciative of the services received. We couldn't expect the quality of what we receive to be better!"

"(My caregiver) is a perfect caregiver. She does what I ask her to do. She is always friendly and makes me laugh every time she comes."

The Lifeline

2011-02-21T12:29:00.000-07:00

(I hesitated to post this, since it does express a little about my belief in spiritual matters. I will just say that we respect, work with, and help people of many different beliefs, or no belief at all.)

We could never get across to people that we were desperate, not saintly. We could no more stay away from church at that time than we could stop breathing. God was our lifeline; our "oxygen" as Avalon sings it. The Lord took care of our need by making sure we could get to church every time. It was just one of the miracles that ocurred during a very hard time.

When my late husband was sick there was much that could go wrong from hour to hour. I was so busy taking care of a baby girl, a small boy, and a very sick husband, that I had no time to even wash my face or brush my teeth most days. I couldn't even finish one meal during the day. An hour after leaving the table, I would dump the food off my plate, wishing I had time to eat it.

But Sunday morning, things went smoothly and I could get everyone ready for church. My husband never got sick when it was time to be at church. I had time to dress a baby girl, put a hat on to hide my dirty hair; and towards the end, help my husband get dressed. He was able to go to church the last Sunday before he died.

It was one of those things I didn't notice until it was long over. It would seem like a small thing to someone who has no idea what it's like in that situation. It was not small.

Care Giver Classes

2011-02-10T13:23:00.000-07:00

A free caregiver class is given once a month at the Ethel Berger Center, 2950 E. Tacoma St., Sierra Vista, AZ. Family and professional caregivers are welcome. The sessions include time for questions, problem solving, and support. Presented by the Area Agency on Aging. For more information call the AAoA at 520-432-9681.

The next class is February 17, 2011, 1 pm - 3 pm. Speaker: Melinda Haun, R.N., CPH. Subjects: Diet, nutrition, special diets, weight loss with some illnesses, food for the home bound, optimizing bowel and bladder function.

Senior Expo: A Fun, Informative Event

2011-01-19T14:40:00.000-07:00

The Eleventh Annual Senior Expo will be February 19, 2011 at the Ethel Berger Center, 2950 E. Tacoma St., Sierra Vista, Arizona. There will be exhibits and displays from home health care agencies, retirement centers, health fitness professionals, financial advisors, and more.

Some of the organizations there last year were: Senator John Kyle's office, Representative Gabrielle Giffords office, Social Security Admin., SEAGO, VICAP, CANTER, AIRES, Advantage Medical, Sierra Vista Transit, Sierra Vista Police, Air Evac, Sierra Vista Parks and Leisure, DES-DDS, Cochise Ability, Low Vision Support Group, Southern AZ Legal Aid, and the Commission on Disability Issues, and Comfort Keepers.

Entertainment and mini-seminars are usually provided. Lunch will be served in the cafeteria. Coffee and muffins or doughnuts will be available most of the day.

A couple of the mini-seminar speakers and subjects are listed at Bazaars and Expos on the city services web site.

Here are some photos from last year's Senior Expo.

The Arthritis Brothers were fun to listen to.

Hand Made by Pam: Wheelchair bags, walker bags, and walker purses. Sewn by a disabled entrepreneur.

We (Comfort Keepers) will be among the vendors displaying information about our services. Stop by our table to meet us and to sign up for our free drawing for a $25 gift card to Applebee's.

The Senior Expo is a fun way to gather information, pick up free give aways, win prizes, ask questions, have lunch, and enjoy some entertainment.

For more pictures of last year's Senior Expo go to our Photo Album on Facebook.

We hope to see you there!

Those Endless Phone Calls For Help

2011-01-14T14:28:00.000-07:00

Image via Wikipedia

When my late husband was sick, I had little extra time to spend on washing my face, let alone for making telephone calls. When friends discovered that I had needed help with a situation, they asked why I had not called. They assumed I was reluctant to ask for help. I never could get across to them that my problem was time.

I would not call until I needed help with a crisis because telephoning took up time I just did not have. It took multiple calls to find one person who could help. Each call began with the required "How are you" conversation, and most ended with a long apology and an explanation why the person could not help this time, with a request to please call the next time. If each call took a minimum of 4 minutes, and six calls were needed to find someone to help, then 24 minutes were lost. Do the math for six minutes and eight calls. I was far too busy.

One thing about our office making multiple business calls to caregivers, is that the small talk is usually eliminated. Caregivers and office staff like to get to the point.

Family caregivers who utilize a caregiving agency like ours can reduce quite a few extra phone calls looking for help. It's one of those time savers that people do not think about when they think of involving a home care company. And all those calls are at no extra charge!

It is also possible that a friend would be willing to make those phone calls for the caregiver. One of our friends began doing that for us and it helped tremendously.

No matter your source, be sure to get that help, you need it.

Long Distance Elder Care

2011-01-11T16:05:00.000-07:00

Image by Getty Images via @daylife

Adult children can have a difficult time keeping up with the day to day issues that occur while caring for elderly parents from a distance. A good deal of time can be lost during a child's work hours with telephone calls to set up medical appointments, set up transportation, inquire whether a father took his medications, track what groceries are needed, verify whether or not a mother is eating properly, discover whether dad is becoming depressed or mom is getting enough exercise and recreation.

Home care agencies can help by providing local eyes and ears that report to a family member. A caregiver can accompany an elder during a doctor visit, take notes, make a report on the doctor's recommendations, provide information about the next appointment, and pick up prescriptions.

A caregiver can also keep an inventory of the groceries, help with shopping, observe if the house or the client is too hot or too cold, note if the client is doing well or slipping in areas of function, and keep a written record of how an elder is doing.

Our office also helps by providing a secure online view of a parent's care schedule, the ability to request a change of schedule while the family member is viewing it, e-mail invoicing, online bill pay, and of course, telephone, fax, and e-mail communication.

In addition to that, our office provides a remote time clock which verifies that a caregiver is at an elder's home. We also make periodic assessments of an elder's needs and the quality of service provided. Any change in needs can be reported to the family member involved in the elder's care.

The adult child can save time and money as a result of less travel and fewer telephone calls. In the long run, having some hired help reduces stress which can help an adult child's well being.

Giving All Year Round

2010-12-14T20:44:00.000-07:00

Did you know that you can donate to SEAGO-AAA (SouthEastern Arizona Governments Organization - Area Agency On Aging) to provide funds for helping the elderly in this area? These funds help provide housekeeping, personal care, respite care, home health services, congregate meals, meals on wheels, transportation to medical appointments, and more. While SEAGO-AAA provides services to the elderly regardless of income, and some of the elderly actually donate money for the services they receive, there are many who cannot afford these services.

To donate to AAA directly, send your check to SEAGO-AAA, 118 Arizona Street, Bisbee, AZ 85603, and specify "SEAGO-AAA donation". For more information: 520-432-5301, http://www.seago.org/aaa/index.html.

If you prefer to donate online, our business is set up to receive payments or donations through PayPal. Keep in mind that approximately three percent of the donation will go to PayPal's payment processing fee. To donate online, go to http://www.paypal.com/, click Send Money, then send payment to svservice@msn.com. You will be taken to a page that says you are making a payment to Comfort Keepers #194. In your payment description or notes, specify "SEAGO-AAA donation". We will e-mail you a receipt for your donation, and if you provide your address, we will snail-mail an annual statement in January.

The donations we receive are reported to SEAGO-AAA every month and deducted from what SEAGO-AAA pays to us for the services we provide to their clients. This leaves extra money above SEAGO-AAA's budget that is used to provide services to more elderly than would be served without the donations. There are a number of service providers who collect donations in this way for SEAGO-AAA.

However and wherever you choose to give, we wish you a wonderful holiday season!

Our Local International Medical Tourism

2010-11-27T19:27:00.000-07:00

Many people are leaving the country to receive medical treatment. Even with transportation and hotel accommodations, they are finding the total cost cheaper for many surgical procedures. Fortunately, the Joint Commission, which accredits US hospitals, is now accrediting foreign hospitals as the Joint Commission Internatonal.

The IndUShealth website lists prices for surgeries outside the U.S.

Even some medical insurers in the US are covering foreign treatment because it costs less for the insurance company. You might check with your insurer.

If you don't have insurance, obviously you will need to spend from your savings, but if you have the resources, you can save a considerable amount of your money.

There are caveats whether you are looking for medical care in or out of the country. This article notes some warnings, What You Need to Know.

For further research into medical care, check the links in our previous blog article, The Treatment Trap.

Like many people, I find the cost of medical and dental care prohibitively expensive at home. I recently took my son to have his wisdom teeth extracted at Quality Dental in Naco, Sonora. I am pleased with the quality, the convenience, and the cost.

My son's dentist, Dr. Morachis, does not speak English, but his assistant/ receptionist translates. The dental operatory also has post-treatment videos in English, to inform the patient about what to do after a procedure.

After leaving the dental office, we picked up a post-extraction prescription (also very inexpensive) at the pharmacy next door, crossed the street, walked through the border station, got in our car and went home. We live less than an hour from Naco.

In Naco I paid $133 for the initial exam, x rays, the first two extractions, and the prescriptions. So far the cost has been about a third of what we would pay in the U.S. I checked Dental Costs to get a range of dental prices in the Tucson area, which is as close as I could get to Sierra Vista.

If you are interested, here are links for Quality Dental, that provide a US phone number to call to make an appointment, a video showing their office, a map to show how to get there, and their dentists and services.

Quality Dental Mexico

Quality Dental Care

To get there:

First get your passport.

Drive to Naco, Arizona. Turn off towards downtown Naco. Ignore the sign that says there is no border crossing in town. That is for vehicle crossings. When you get to the center of town, park on the street in front of the border station and walk through. If you haven't been through before, you can ask the border patrol there to check that your passport is in order, otherwise you do not need to show it on your way out of the U.S. You will need it to get back in.

If you are headed for Quality Dental, just cross the street after you walk south of the Mexican border office.

There are multiple dentists and pharmacies in Naco; I also saw an optometrist there. It is obvious that Naco, Sonora caters to medical tourism.

If you need a ride there, Arizona Sunshine Tours gives rides to Naco, Sonora. To quote Arizona Sunshine Tours' post on our Facebook page, “For inexpensive dental care...consider a private driver and escort for quality dental work in Naco at www.qualitydentalmexico.com.”

While there, treat yourself to a paleta at one of the Michoacana's nearby. These are popsicles made with fresh fruit, not too much sugar, and oh so delicious. Currently the cost is 10 pesos or $1 US.

There is a little food stand in a camper across the street from Quality Dental. He has great Shrimp Cocktails for about $7 US. There are quite a few cafe's and food stands, as well as tortilla and bread shops.

If you want to visit a few shops you might use google translator, before you go.

Photos of Naco, Sonora

Quality Dental, and the Pharmacy next door.

This little stand offers great Shrimp Cocktails.

One of the two La Michoacanas in Naco.

Inside Quality Dental's waiting room. Decorated for Thanksgiving or Autumn.

Movies are often shown in the waiting room.

The Treatment Trap

2010-10-30T16:08:00.000-07:00

I just finished reading The Treatment Trap by Rosemary Gibson and Janardin Prasad Singh. I strongly recommend that everyone read this book. If you are considering a medical procedure and want to have all the information about the risks and benefits, there are resources in this book to help you do just that. A few such resources are:

HealthNewsReview.org, experts review medical news stories for accuracy.

Foundation for Informed Medical Decision Making, provides DVD's that give information about a medical procedure. www.informedmedicaldecisions.org/patient_decision_aids.html

Dartmouth Atlas has a web site that shows large differences in how often certain procedures are done in various communities and hospitals around the country. A high rate for a procedure is a red flag. http://www.dartmouthatlas.org/, go to download, go to surgical discharge rate, then hospital referral region or HRR.

Cochrane Consumer Network reviews medical interventions. Their reviews are the gold standard and are published online. www.cochrane.org/consumers/about.htm

There is much more information in the book.

Passages In Caregiving by Gail Sheehy

2010-09-28T13:19:00.000-07:00

This book equips the caregiver to surround him or herself with others who can help. You can't do it alone. From professional assistance to family and friends, this book talks about how to get the people you need to help your loved one. If you are anticipating caring for someone in the future, or are already there, you need to read this book. Bring a pencil and pad and some sticky notes, you're going to want them. This is a practical book as well as a book of helpful stories. There are also a number of useful web sites mentioned in this book. Click the title to go to Gail Sheehy's web site.

The Professional Caregiver Needs Care Too

2010-09-22T12:28:00.000-07:00

Professional caregivers need time off too. Paid caregivers can burn out quickly if they are not careful. One of our jobs as office staff is to watch for caregiver burnout, and reassign caregivers when they need a break from a client who is taxing their resources.

Caregivers do not always understand this and sometimes become upset with us. We do our best to explain that we think it is the best thing to do for them. Others are relieved that we did for them what they did not feel they could do for themselves. We have found that our caregivers stay with us longer if we reassign them.

But caregiving is taxing; sooner or later, a caregiver has had enough and wants to move on to other work. Only two caregivers were with us for seven years, one has been with us eight years.

I feel the stress myself, and I seldom do the actual caregiving. There are times when I feel just like I did when I was taking care of my terminally ill husband. In the office we are constantly taking phone calls from people who have problems that need to be solved, who are anxious about how their care is going to be provided. We are aware of their illnesses, their states of mind, and their family dynamics. We fix what we can, we ponder the rest and have to let go of what we can do nothing about. But it does take its toll.

Parenting is Not a Lone Ranger Activity, Neither is Elder Care

2010-09-10T08:53:00.000-07:00

When a child is growing up, a normal parent does not say, “I'm the only one who can take care of my child.” Yes, many new mothers say this at first. They are terrified to leave their new baby with anyone else. But mothers get over it quickly enough when they realize that they need some time out from being at the constant beck and call of a helpless human being.

Caregivers of adults need to come to the same realization. They need to look at the possibility of caregiving becoming long term and take the steps needed to take care of the caregiver.

The adult in need of care can lay guilt on the caregiver, saying that the caregiver is the only one he or she wants taking care of him or her. Parents are familiar with small children protesting when a parent leaves them in the care of another. If you were a parent, you did not allow your child to run your life (I hope), so do not allow your ailing loved one to run your life. It is possible (and necessary) to love, care, and have part of your life separate from your needy loved one.

Web Conference: Making Informed Senior Care Decisions

2010-09-03T10:29:00.000-07:00

National Private Duty Association web conference: Home Safe Home: Making Informed Senior Care Decisions. September 23, 2010, 7 pm CDT. Live and interactive, advice on hiring a home care provider. Free of charge. Pre-registration required. http://www.privatedutyhomecare.org/

Topics include understanding the different types of home care providers, service levels and associated costs, important differences between provider types, and information resources to help you find a home care provider.

QR Code for the Elderly

2010-08-24T14:01:00.000-07:00

Should the elderly have QR Codes for emergency services? Could these codes be linked to existing PERS equipment, or to the local 911 service? A fireman, for example, could use the QR Code to retrieve information about the residents in a home. The number of people who live in the home, their names and basic medical issues, mobility issues, age, mental status, whether or not the person has a DNR, the relatives to telephone in an emergency, the primary physician, all would be usful information for emergency services. I googled this idea, but have not yet found anything about its use for emergency services. Has anyone seen this idea anywhere else?

Licensed In-Home Nail and Hair Care by Sonya Cordova

2010-08-20T10:34:00.000-07:00

Sonya is among the few beauticians who have a license to go to the home of the elderly and house-bound. If you would like to have Sonya's telephone number, call our office at 520-417-2000, or call Smart Look Salon at 520-459-5092.

The in-home nail and hair care is a service Sonya provides through Smart Look Salon and Nail Spa in Sierra Vista. Sonya has also worked for us as a caregiver for the past year. We would like to help her services grow, because it is such a needed service.

Adapting Your Home for Family Members With Alzheimer's or Dementia

2010-08-19T08:54:00.000-07:00

Good information in this article. Caring for a family member with dementia can be challenging. This article talks about simple but effective ways to reduce the burden on the caregiver and increase the safety of your family member. Most important, it talks about when to implement these changes.

Home Care After Hip Replacement Helps Elderly

2010-08-18T08:40:00.000-07:00

Here is a study that shows the significant value of home care for the elderly. This study is specifically about the care received after a fall and hip replacement, but it applies to other situations as well.

We have long known that our clients do much better when they accept all the help they need. We have seen people refuse all home care just to end up as permanent residents in a nursing home within weeks. Some clients ration the care so severely, that they do not get the full benefit of what they need.

Others take all the help they need at first, and experience a sudden and dramatic increase in health and well being. They then decide they do not need any more services. But without that extra assistance they go downhill quickly and need our service again. Some will take our advice to taper off the care, rather than dismissing services suddenly. Those who do this fare much better.

Home care is definitely worth the expense. Not only does it aid in recovery after an injury or illness, but if used before such an event, it can prevent or reduce hospitalizations. Come to think of it, that is the result of another study. I will have to find that one.

Monitoring Technology: Watching Our Parents

2010-08-12T16:12:00.000-07:00

This article is more useful than most on the subject of using monitoring technology for aging parents.

Client Satisfaction Survey

2010-08-10T15:07:00.000-07:00

Our national franchisor conducted their six-month client survey last April. We just received the results. Once again, the responses were very positive. Nationally, 97% of those who responded to the question, "Would you recommend the use of Comfort Keeper services?" indicated that they would.

Five of our local clients responded to the survey. Four surveys rated our services Good to Excellent. One survey did not rate our services at all; apparently a family member was returning the survey on behalf of a client who had passed away.

We have, in the past, received some mildly negative responses mixed with positive responses in these surveys. But it is nice to know that we are improving and continuing to do a good job in meeting our clients' needs.

Questions were asked about the quality of the initial contact, ongoing relations with office staff and the quality of the caregivers. There was also room for comments.

Free Video Caregiver Classes

2010-08-06T13:34:00.000-07:00

If you are providing care for a family member you might like to watch a video that demonstrates some "how-to" skills. Or maybe you are thinking of a career in caregiving. We have caregiving videos available for viewing in our classroom. Please call us at 520-417-2000 to make an appointment to view topics of interest to you.

Current videos available: Caregiver Wellness (very important for family caregivers, but also for career cargivers), Fall Prevention, Elder Abuse and Neglect, Caring for someone with mid to late stage Alzheimer's Disease, How to communicate with someone who has Alzheimer's Disease, Managing Medications, Bedrest Skills, Wheelchair and Walker Skills, Nutrition and Meal Preparation for Older Adults, Companion Homemaker Roles and Responsibilities, Companion Homemaker Safety and Housekeeping, Cultural Competence, Infection Control, Diabetes and Depression, Personal Care.

SEAGO Cochise County Elder Resource Guide

2010-08-04T11:11:00.000-07:00

On the right side bar of the SEAGO page is a link to several directories, including the Cochise County Elder Resource Guide. We use this guide in the office because it is full of useful contact information. It is updated about twice a year.

How is the Economy Affecting You?

2010-05-01T12:14:00.000-07:00

Some people are saying the economy is recovering. I’m seeing mixed signs of that. We are receiving a few more inquiries about services, and we are finding it slightly more difficult to hire caregivers in certain communities. But we are not yet able to restore the pay cuts we had to implement due to fee cuts made by the state. And more cuts are said to be on the way.

How about you? Is the economy affecting the decisions you have to make about hiring some extra help for senior care? Are you looking for technological alternatives to in-person caregiving? Are you depending on friends, neighbors, and family more for the care that is needed? Are you wearing yourself out trying to do most of the care for your elderly loved one?

FREQUENTLY ASKED QUESTIONS, FAQ

2010-03-26T17:40:00.000-07:00

Do you perform background checks on your caregivers?

Yes. We screen for criminal records, motor vehicle reports, employment history, and personal references. We require each caregiver to obtain the Arizona fingerprint card, which includes an FBI check. We also use a screening service that provides in-person checks of court records in each county of a caregiver’s residence. We also use a Social Security trace to locate each county of residence and each name associated with that S.S. number. We have additional sources for local background checks. We are very thorough, because your confidence in our caregivers is very important to us.

How do you monitor my caregiver’s performance quality?

We periodically visit with you at home and by telephone. We encourage your telephone calls to tell us how you like or do not like a new caregiver. We also talk with the caregiver whenever she comes to the office to determine her attitude towards each of her clients and her duties. We take appropriate action as needed because your satistaction is important.

How do you make sure that my caregiver will arrive on time?

We use a remote time clock system. We know if your caregiver is late or hasn’t arrived. Barring glitches in the technology (and they occur often enough), we are able to take action within about twenty minutes of a non-arrival.

How soon can I start to receive services?

This depends on the number of hours needed per week, and the availability of our caregivers. If we have recently hired several caregivers who have plenty of available hours, we can schedule you within days. But it can take two or three weeks if you need more than, say, 20 or 30 hours a week and our caregivers are all working near their maximum available hours.

Will I have the same caregiver every time?

We do try to schedule as few caregivers per client as possible. We know consistency is important to you. Most clients have a primary caregiver who is there most or all of the time. But if your caregiver is sick or on vacation, we will need to send a substitute.

If you need service in the morning and again in the evening, you will likely have two different caregivers.

If you need more than twenty hours a week, we will schedule two caregivers so that each can be a substitute for the other when needed.

If you need about thirty hours of care a week, we may start with three or more caregivers until we can find a good match for you and settle into a permanent schedule with two caregivers.

If you suddenly need 24/7 care, we will put together a schedule using several of our caregivers. You could have six or more caregivers, until we can hire more caregivers and settle into a more permanent schedule.

Why do I keep getting different caregivers?

There could be a number of reasons for this, a few are:

We may be in a period of seasonal flu, requiring substitutions for sick caregivers.

We may have added a temporary client whose schedule requires that we juggle a number of caregiver-client schedules.

A caregiver may have resigned, causing us to re-align a number of schedules. The re-alignment will continue until everyone finds a good client-caregiver match.

How often can I change my schedule?

At first you may be making adjustments to your schedule until you know what works best for you. But we prefer that you not change your schedule for the current week. If you want to make a change, please plan ahead for the following week. Tell us no later than Wednesday of the week before you want to make the change.

If a sudden medical appointment comes up, or you forgot something on your calendar, we will do our best to accommodate a change to your schedule for the current week. But we cannot guarantee that we can provide a caregiver for the change on short notice.

Why do you prefer that I not change the current week’s schedule?

Our policy exists for several reasons. Your caregiver is depending on a steady income, and that is difficult with sudden cancellations. Also he really needs to know what his schedule is for the week so he can plan his week around his work schedule. We cannot always contact your caregiver in time to notify her of a change. A caregiver does not like to show up at a client’s door to discover that his schedule has been cancelled or changed to another day.

If the schedule is constantly changing, confusion causes appointments to be missed in spite of our best efforts. The schedulers become confused, and the caregiver’s can’t remember which schedule change is current. This is a big reason to limit schedule changes.

Another point is the amount of extra scheduling time that is required for schedule changes. Schedulers cannot work on the following week’s schedule if they are bogged down in multiple changes to the current week’s schedule. We could hire a scheduler just for the current week’s changes, but then we are back to unstable caregiver schedules with all the problems that entails. And hiring a scheduler just for making changes to the current week’s schedule would cause a need to raise your fee. We assume you do not want that.

How late can I cancel a home-care appointment?

If you do not want to be charged for the cancellation, please tell us at least by Wednesday of the week prior to the cancelled assignment.

Can I arrange schedule changes with my caregiver?

You may discuss the possibility of a change, but then you need to telephone the office to discuss the change with us, since we do the scheduling. Your schedule change may affect other clients and other caregivers, so we need the information as soon as possible.

Another aspect of this, is the caregiver’s desire to please everyone. Some caregivers will agree to anything a client asks, but then will tell us in the office that they cannot possibly add anything more to their schedules. We say, “No,” when the caregiver can’t bring herself to do so. If we do not, a good caregiver will resign when she becomes exhausted.

May I ask my caregiver to stay a little later to do some more work?

Maybe. If he has another client after you, or a personal obligation, he will not be able to stay. Please try to schedule all the time you need before hand.

Is it okay to ask my caregiver to work a few minutes extra for free?

No, for several reasons.

Your caregiver is not covered by worker’s compensation insurance while “off the clock”. This leaves you and us potentially liable for any injuries to the caregiver.

Your caregiver is legally not allowed to work off the clock. The Arizona Department of Labor could require us to pay estimated back wages for not only your caregiver, but all caregivers, as a result of one caregiver complaining that she had to work for free.

Also, your caregiver needs to make a living. Time spent working for free will reduce the time she has available to work for pay. If his work is of use to you, he should be compensated for his time.

What happens if a flash flood keeps my caregiver from arriving on time?

During the rainy season, floods can cause a number of caregivers to call within a short period of time to say they are going to be late. We will telephone you to inform you of the estimated time of arrival and ask if you need a substitute before then. If we are having a large number of caregivers unable to arrive on time, we may have to determine which clients are most in need of a substitute caregiver.

What happens if my caregiver is too sick to work today?

We will telephone you to inform you that we are searching for a substitute and will telephone again to inform you at what time we expect your substitute to arrive. You will have the option to accept a substitute or not. If your caregiver was to provide transportation to an appointment, we will make it a priority to get you to that appointment on time even if one of our office staff has to do it.

How and when do I pay for services received?

We can mail, fax, or e-mail your invoice weekly or monthly. If you want a monthly invoice, we require prepayment of an estimate for the coming month.

You can pay by check, major credit card, or by PayPal’s online payment service, which includes e-check (debit), and credit card payments.

Do I provide a meal for my caregiver during mealtime?

Not unless you have required the caregiver to accompany you to a restaurant. Otherwise, your caregiver brings his meal to your home to eat during meal time.

I would like my caregiver to provide transportation to my favorite restaurant once a week. Do I need to pay for her meal?

Yes, unless she has brought a sack lunch with her.

Can I pay a tip or give a gift to my favorite caregiver?

We prefer that you telephone for our approval first, and that you keep the value of the tip or gift within twenty dollars. There are good reasons for this; primarily to avoid any appearance of a caregiver taking advantage of someone.

My hand is too shaky to write checks anymore. May the caregiver write checks for me?

Yes, but you must sign your checks. We also need to know that the caregiver is writing your checks.

May my caregiver change my bandages?

Not anything more than a band aid. Our caregivers are not licensed for wound care.

May my caregiver dispense medications?

No. Your caregiver can provide medication reminders, and she can observe and record that you have taken your meds. But she cannot set up your meds into a pill box, or an automatic dispenser. He cannot take a bottle of medication out of your cupboard and tell you it is time to take that medication. She can give you your medication box. He can assist you with opening the bottle of medication that you have chosen to use. She can read medicine labels for you.

If you need someone to set up your medication box, you will need a licensed home health nurse, a friend, or a relative to do this for you. We can refer you to home health agencies in the area that provide “med sets”.

May my caregiver cut my hair?

No, she is not a licensed home hair stylist. We can refer you to a licensed home hair stylist who will come to your house.

May my caregiver trim my toe nails?

No, he is not a licensed podiatrist, home health nurse, or nail salon specialist. He is permitted to file nails, but not to cut them. Diabetes, blood thinners, compromised immune systems, fragile skin, and other conditions and medications can make nail trimming hazardous. We can refer you to a licensed nail salon specialist who will come to your home.

May my caregiver lift me out of my chair?

No, our caregivers do not lift. Our caregivers may provide assistance in transferring you from bed to chair to toilet, etc. But you need some mobility. If you need more care than this, we can refer you to a home health agency. If you are not sure how much assistance you need, we can provide an evaluation of what type of service you need and make referrals if necessary.

Some of our caregivers can operate a Hoyer Lift for you, if your mobility is severely limited.

Do you provide bed care?

Yes, we can provide bed baths, position changes, occupied bed changes, assist with your meals, and assist with your personal hygiene. To provide help with feeding, an intact swallowing reflex is necessary. We do not provide tube feeding, ostomy care, or catheter care.

May my caregiver dust the top of my refrigerator and wash my windows?

Yes and no. For occupational safety and worker’s compensation insurance reasons, our caregivers are not allowed to get onto chairs, stools, or ladders. The caregiver may do what he is tall enough to do while keeping his feet on the floor.

May I ask my caregiver to take care of my yard?

If you want to get out for some light yard work and pull a few weeds around your flower bed, your caregiver may assist you. But for anything more, you will need a yard maintenance business to provide yard service. Again, we have occupational safety and worker’s compensation limits. Our caregivers are not trained in the occupational safety aspects of yard work.

If I need to know who provides good yard work, car care, or accounting services, who do I ask for a referral?

If you find that you need services we cannot provide, call our office for a referral. Our caregivers are not allowed to make any referrals or recommendations for any services of any nature.

May the caregiver drive my car when I need transportation or shopping?

Yes, if your car is road-safe, licensed, and insured. Otherwise, the caregiver will drive her car and we will charge you a mileage fee which will be paid to the caregiver to reimburse her for gasoline and car maintenance.

Are your caregivers bonded? Do you carry liability insurance?

Yes, and we inform our caregivers of their responsibilities under the laws regarding home care.

Do you have worker’s compensation insurance for your caregivers?

Yes, and we inform our caregivers of their responsibilities to stay within the limits of our insurance policy requirements.

Do you pay the caregiver’s Social Security, unemployment insurance, and withholding taxes?

Yes. They are our employees, not “contracted workers”.

How do I terminate all services?

We ask that you inform us two weeks before the date you want services to terminate. This allows us to find other assignments for our caregivers, who depend on their schedule for their income.

How can I reach the office after hours and weekends?

We can be reached 24/7 at the telephone numbers we give you when you sign up for services. Urgent calls are forwarded to our on-call staff. If the call is not answered immediately please leave a message and your call will be returned as soon as possible. If you have a medical emergency, please call 911.

How do I get my parents to accept home care services?

You may see our blog, at http://comfortkeeperssierravista.blogspot.com/, for some topics on this. Some of these articles are available in our home visit packet.

FAQ, faq, Frequently Asked Questions, frequently asked questions.

Elders Falling Through The Cracks: Arizona’s Budget Cuts

2010-03-15T14:52:00.000-07:00

Cuts to the Arizona state budget are hurting everywhere. The Arizona Long Term Care System cuts are obvious to us, since we see the effect on many of our clients. A little help at home is often all that is needed to prevent major health problems in the elderly, and allow them to live out their days as they wish.

The annual cost of home care is usually far less than the cost of care in a facility, even though the hourly fee for home care is higher. For most people, fewer hours are needed to provide assistance at home.

This budget cut is short-sighted. Within months, there will be a resulting increase in hospital and nursing home admissions, which will be at least partially paid for from Arizona’s Health Care Cost Containment System, and Medicare.

We saw people falling through the cracks before the budget cuts started last year. We are not looking forward to watching the declining health of our ALTCS clients as a result of these cuts.

Living In The Past: Reflecting On One’s Life

2010-02-19T12:03:00.000-07:00

Reflecting on the past seems to be a natural process of aging. As we age, we want to process and categorize our memories since we have time to do so, deciding what was important, what was good, what was bad. Regrets can be large during reflection, but so can happy memories.

Even with dementia, the past can be reflected upon. It may look different, since the elder with dementia may act towards family members as if he or she was actually in the past. Adult children should not be distressed by this, but take it as an opportunity to learn more about a parent’s history. Little gems of memories can sparkle for one, if one has the patience to enter the past with an aging parent.

An Elder’s Walk Through Memories

2010-01-02T11:35:00.000-07:00

He was enjoying the amatuerish Christmas drama playing outdoors on a cold December night. His comments revealed how delighted he was, with a combination of childish enthusiasm and adult experience.

A local church’s annual Walk Through Bethlehem provided the elderly gentleman with plenty of scenes to comment on, and actors to converse with. When the hills of Judea were mentioned, he informed us that he was from Israel. He probably was; he spoke with an accent. He explained some history to the “Roman Guards”.

A pleasant, patient woman who was either his caregiver or his daughter, kept an eye on him, since he tended to wander off to talk with people. She had obviously brought him because she thought he would enjoy the historical setting. Neither he nor his caregiver realized how much enjoyment he brought to me and others that night. I spent a good part of my time watching him, rather than the actors, because his reactions were so charming.

An elder with dementia can offer unexpected gifts to the rest of us, if we are patient and remain willing to learn.

Seniors’ New Year’s Eve Party

2009-12-18T12:19:00.000-07:00

Green Valley Comfort Keepers and Green Valley Village mall are sponsoring a New Year’s Eve at Noon Party, December 31, 2009, 11 am to 2 pm, at the Green Valley Village, Suite 31. Refreshments, dancing to music from the 1930’s through the 70’s. Toast the New Year at Noon with Sparkling Cider.

Come prepared to have fun!

The Occasional Meal

2009-11-29T09:55:00.000-07:00

Tip: When taking a meal to someone, put the food in containers that you do not want returned. It is not a burden on the recipient if he or she does not need to clean and return the containers. The elderly and disabled can find it difficult to return items. A family caregiver does not have the time to spare.

Plastic bags hold salad nicely. Jars or plastic containers can hold most meals.

Green Valley News

2009-09-15T08:32:00.001-07:00

Green Valley News & Sun - Business > Business > In-home care service opens

Posted using ShareThis

This is a link to an article about our satellite office opening in Green Valley, Arizona. Our Grand Opening is Wednesday, September 16, 2009 from 11 am to 4 pm. Stop by for a visit!

A Dramatic Turnaround

2009-07-18T10:13:00.000-07:00

Mr. Simmons (all client names are changed) was on hospice care and was almost bed ridden when his daughter requested that we come in several times a week to provide care. Hospice does a very good job, but they are limited in the amount of time they can spend. Mr. Smith’s wife was protective and wanted to take care of him herself, but she has health issues that make it difficult for her to do all that is needed. He was passive and did not talk.

We have been there for several months now. At first we provided help with getting dressed, with hygiene, meals, and getting him moved from the bed to a chair for the day. Included was a little exercise.

Mr. Simmons has moved from his hospital bed to the master bedroom. He is also walking with the caregiver outside and down the street to the corner and back. He has started to talk and laugh with the caregiver. Even though he is still diagnosed as terminally ill, his quality of life has increased considerably.

Mrs. Johnson has better memory and improved health since we have been with her for a few months. Her daughter took her to the doctor recently. Her physician was impressed with the improvement in her many health issues. Her daughter couldn’t say enough good about the changes she has seen in her mother as a result of our help.

Mrs. Larson was depressed and easily distressed when we began to provide home care for her. She is showing signs of coming out of her depression, even in the face of some truly distressing news this week. Having a caregiver to talk to and provide emotional support, as well as housekeeping, cooking, and shopping for her, is beginning to make a difference.

Providing for such basics as good food and exercise is helpful in improving a person’s overall health. But home care is more than just providing for basic needs. Having someone to talk to can improve one’s outlook on life. Combined, the provision for basic needs and companionship can greatly increase a senior’s quality of life. That affects the happiness of the entire family.

Local Sources of Information

2009-07-02T16:35:00.000-07:00

Here are local links to information and directories.

Info SEAZ has directories of elder care resources for Graham, Greenlee, Santa Cruz, and Cochise Counties. There are other directories as well, for disability services, youth services and more.

For information about Pima County Elder Resources go to Pima Council On Aging.

Cochise Health Systems is the county contractor for the Arizona Health Care Cost Containment System/Arizona Long Term Care System (Medicaid).

South East Arizona Goverments Organization, Includes the Area Agency on Aging. They offer guidance on a number of aging issues, from reverse mortgages for funding home care to family caregiver resources.

You will find Comfort Keepers in the Elder Care Directory for Cochise County. We provide home care services for Cochise Health Systems members, and for SEAGO-AAA clients.

Remote Time Clock and Internet Scheduling

2009-06-24T16:00:00.000-07:00

Yesterday morning was worrisome. The late caregiver alert rang on the cell phone at twenty minutes after the scheduled arrival time. The client needs help getting out of bed, and is located thirty miles away. Someone had to get there.

I brought up the day’s status screen on the internet and began making calls to potential substitutes. I was leaving a message for a caregiver when the status changed to arrived. I abruptly changed my message, then called everyone else that I had a left a message for. The caregiver may have been waiting in some local road construction. So we notified other caregivers to set out early.

The remote time clock is integrated with the scheduling system. We can access the schedule at any time, and anywhere we have secure internet service. During the weekend and after hours, the on-call office staff can use the system from home to make changes to the schedule as problems develop. The cell phone allows us to go about our weekend activities while receiving alerts.

The remote time clock automates the verification of caregiver arrival and departure. The caregiver uses the client’s telephone to clock in and clock out. With day-after verification of the telephone number, we can verify the client’s phone was used without paying the high Caller-ID rates.

We have used this system for several years now and would not want to go back to the old system of “no news is good news”. Not every client will telephone to say that no one has arrived. Some people do not want to make a big fuss, others cannot remember what the schedule is, some have family members who take over the task at hand and forget to call until later. It is so much better for everyone to have an automated accountability system.

View Your Schedule On The Internet

Your own schedule can be accessed by you or your family members (with your permission). This is very convenient when people want to verify their schedules.

Our Mature Workers' Hall of Fame

2009-06-18T18:56:00.000-07:00

One of our caregivers retired at age 79 a few years ago. Edith was still going strong, but had too many duties at home, and was feeling the tug of age. She called herself “The Great White One” when I answered her phone calls, referring to her white hair. I called her “The Little Old Lady From Pasadena” because she had a new car that she drove with a lead foot. She loved it.

Our current oldest employee is 78 years and works 30 hours a week. Gloria walks with a limp, never complains, is always cheerful, and knows how to work with people.

Sadly, two of our caregivers passed away while employed with us. Terry was age 62 and barely retired from civil service at Fort Huachuca. I was talking with her about a promotion to a part-time office position, but she passed away suddenly. Charity was age 80 and determined to keep going to the very end. She had multiple health issues that she never mentioned, and a desire to get out and meet people. Helping others gave her great pleasure. She worked for us until two months before she passed on.

This looks lopsided, mentioning only women. We did have a man, age 79, with us a few years ago as well. It seems to be the difference in life expectancy, as well as the fact that fewer men apply for this type of work. We always seem to need more male caregivers than we actually have available.

Our mature workers are dependable; having a strong work ethic, they are determined to get the job done. They provide wonderful role models for younger caregivers. We could not do without them.

It was a no-brainer to apply for and obtain the Arizona Mature Worker Friendly Employer Certification, http://www.azmatureworkers.com/ about a year ago. To re-certify in another year, we will have to document how we encourage mature adults to work for us.

We are constantly looking at new methods to reach potential mature workers, and we are always listening to current mature employees to be sure we adapt to their needs so they can continue to work for us. We need to set some of these processes into a document to be ready for our re-certification. So little time, so much to do. I hope I am not scrambling to write a document at the last minute.

Holding Down The Office

2009-06-13T09:52:00.000-07:00

What a couple of weeks. We’ve been short two office staff. One had a vacation planned, the other had an urgent personal matter that needed attention. We normally have three full-time and two part-time office staff, so missing two people for two weeks is more than noticeable.

Our priority is to be sure that all our clients are receiving their services. Since some are quite needy, continuity of services is a serious issue. I’m happy to say that we have not missed anyone. We did inadvertently schedule a few extra services, but that is safer than not enough. We did fail to call a couple of clients to tell them someone would come earlier than planned. But at least their services were not late or non-existent.

Unfortunately a couple of clients expressed their anger when the caregivers knocked on their doors. It wasn’t the caregivers’ fault! I do wish people would be more considerate of those who are trying to help them.

Some clients have called saying that they have told us this and that already. I’ve finally started pulling out my sympathy ploy; our scheduler is not living the high life on vacation, she is taking care of a necessary issue; we are doing our best to hold down the fort, working extra hours, and we do have a few problems to correct.

The important thing is that we have provided service and not missed anyone.

But more bad news has hit. Our part-time receptionist is resigning and moving out of state. Our scheduler will need another week off. I am going to be pulling out my sympathy card more often next week, I know!

Long Distance Family

2009-06-05T10:43:00.000-07:00

My father-in-law passed away Friday. He was 90 years old. His memorial is tomorrow. Sadly, because I do not have a passport, I cannot travel to Canada to be with the family. My children are able to go, thankfully. But they are taking it hard; their father passed away when they were young.

He had fallen about two months ago. As too often happens, the complications following the fall took their toll. He did not break any bones, but the fall had a devastating effect on his cognitive ability and his mobility. He was in the hospital for several weeks, came home needing home-care services, then went back to the hospital.

My mother-in-law is a retired RN. It has been frustrating for her to see the lower level of nursing care provided in the hospital these days. Daily, she would arrive at the hospital to find that her husband’s needs were not being taken care of.

Since I see what happens to elders in our health care system, I know the system in the United States is badly in need of repair. But I had hoped than Canada’s system was in better shape. I suppose budget constraints occur no matter what the source of funding.

My brothers-in-law had difficulty looking for a good rehabilitation facility for their father. They seemed to be running into the same difficulties in finding a good facility that we have in the U.S. A moot point for them now.

My father-in-law was taking Aricept and some other drugs for cognitive functioning and other issues. A large cause of falls in the elderly are the drugs they take. Some drugs that are supposed to increase cognitive functioning are implicated in causing fainting spells. The elderly are more likely to fall within a few days of a change in their prescriptions.

Stairs are a real hazard, and that is where my father-in-law fell. Other hazards are loose throw rugs, electrical cords, and dark rooms. Probably the most hazardous room in the house is the bathroom. There are plenty of hard surfaces to combine with water and soap to make a slip all too likely.

Some steps to take for safety: Add sturdily-mounted grab bars in the shower, and around the toilet. Add non-slip mats to the shower, and a shower seat if needed. Remove the step-over lip into the shower stall. Get rid of throw rugs, move electrical cords, provide better lighting in dark areas.

I live at too great a distance to be of much help to my in-laws. Their home is on Vancouver Island, their nearest son is in Vancouver, B.C., requiring a ferry to get to them. A niece lives maybe a half-hour north of their home. Naturally, I haven’t had all the details about their needs at this distance.

I’m remembering my father-in-law’s life well led. He was born in England, grew up and attended college in Canada, eventually moved his young family to Oregon. About fifteen years ago, my father and mother-in-law returned to Canada. He outlived two of his sons, tragedies that are all to hard on parents. He has two surviving sons, six grandchildren, and six great grandchildren, soon to be seven.

Useful Links to Information

2009-05-29T10:37:00.000-07:00

Instead of talking today, I’ve listed a number of links to articles and blogs with useful information.

ELDER DEPRESSION

Depression in Seniors, when drugs should be used, when other methods should be used. This is a very informative article.
http://jasonyoung99.wordpress.com/2009/05/14/should-my-loved-one-be-placed-on-an-antidepressant-as-has-been-recommended-by-their-physician/

TECHNOLOGY

When a senior falls at home alone: why you should use fall-alert technology to alert family or emergency services. Good article.
http://ezinearticles.com/?Can-This-Happen-to-Your-Aging-Parent-Or-You?&id=2330848

Links to videos about various technologies to help seniors remain at home, useful.
http://www.ageinplacetech.com/content/videos-and-aging-place-technology

Technology to help seniors remain at home.
http://www.gilbertguide.com/articles/seniors-technology-5-changes-that-promote-aging-in-place/

How the design of a facility or home can help independence.
http://www.gilbertguide.com/articles/how-design-can-foster-independence-in-alzheimers-communities/

CAREGIVING

Books, videos, links, and other sources useful to caregivers.
http://www.squidoo.com/help-4-caregivers

Care for Caregivers
http://www.americustimesrecorder.com/local/local_story_145202423.html

The challenges of Long Distance Elder Care, short article.
http://www.seacoastonline.com/articles/20090524-BIZ-905240327

National Institutes of Health, lengthy but informative publication about Long Distance Caregiving.
http://www.nia.nih.gov/HealthInformation/Publications/LongDistanceCaregiving/

MEMORY, ALZHEIMER’S, DEMENTIA

UCSF Memory and Aging Center videos.
http://www.youtube.com/ucsfmemoryandaging

Alzheimer's Caregiving: Day to Day Challenges
https://www.health.harvard.edu/fhg/updates/alzheimers-caregiving-day-to-day-challenges.shtml?utm_source=twitter&utm_medium=tweet&utm_campaign=0513_tw

Communicating with people with dementia, blog. http://adjix.com/vuw7

INSURANCE

Long-Term Care Insurance
http://www.gilbertguide.com/articles/top-8-facts-about-long-term-care-insurance-in-2009/

QUALITY OF HOME CARE

Arizona Republic article on why non-medical in-home care should be licensed in Arizona. There are very good points and good information in this article about what to look for when searching for a home care providor. This article interviewed Phil Senf, owner of Comfort Keepers in Phoenix, among other providers.
http://www.azcentral.com/arizonarepublic/news/articles/2009/05/24/20090524homecare.html

Preventing or Postponing Dementia

2009-05-21T10:58:00.000-07:00

The brain has remarkable ability to remake and repair itself. Two great books to read about neuroplasticity are, The Brain That Changes Itself by Norman Doidge, and In Search of Memory by Eric R. Kandel.

These books offer evidence that the brain can be exercised to increase its performance. Involving one’s self in a lifetime of learning new things may help keep one’s brain supple. Learn a new language, read, learn to play a musical instrument, play Sudoku and crossword puzzles, do something totally different to force your brain to make new connections. Never stop learning. You may be able to avoid or reduce future dementia and Alzheimer’s. Although much is still unknown about the effects of brain exercise on future dementia, there is enough data to indicate that continuous learning is a worthwhile pursuit.

Taking off with that, I thought it would be a good idea to switch hand functions at times for a little brain exercise. As expected, my left hand doesn’t handle the hair dryer too well. But I discovered my right hand doesn’t sense the temperature and dryness of my hair too well. Obviously the brain can use a little re-training. Anything to increase those connections.

There are numerous computer games available that are intended to increase brain function. Some are quite expensive. Do your research before making a purchase. Google “Posit Science”, “Fast ForWord”, “Nintendo Brain Age”, “brain fitness”, “brain training” , to start your search. Don’t forget the possibilities of the Nintendo Wii, for exercise and mental stimulation.

It is surprising what can affect memory. A strong emotion can make an event unforgettable. An obsession increases memory for the object of the obsession. Falling in love works by a similar process. Depression actually destroys memories. Physical exercise improves memory, and can also lift one out of a depression.

Given that, I should exercise more, and avoid stressful encounters and depressing situations. Hmmm, I already avoid most television news broadcasts. And I consider life too short to spend it with people who would only bring me down. Still, life has its stresses from time to time; none of us are exempt from that. I should control what I can, but not get overworked about the rest. Easier said than done, but I’m getting better with age!

How are you doing at these?

Mom Fearful When I Take Her Out Of The House

2009-05-11T11:10:00.000-07:00

“What can I do when I am out of the house with my mother and she starts calling for help, claiming that she doesn’t know me and I have abducted her?” Sometimes the adult children of our clients ask about this problem. It’s a real concern when a parent’s memory is failing. Some options are to carry identity for both of you that proves you are her child. Your full birth certificate that lists her as your mother would be helpful. If you have any kind of power of attorney, that may be helpful. Of course guardianship documents are useful, but adult children seldom have such a document to show.

It is a good idea to carry all phone numbers of your mother’s relatives, physicians, attorney, minister, neighbor, etc., not only with you, but in your mother’s purse. If someone were to go so far as to call the police to question you and your mother, it will be helpful to have those phone numbers coming out of your mother’s purse, rather than your pocket. If you are taking her to an appointment, have the appointment card to show.

The other issue here, is your mother’s alarm and anxiety at finding herself with an apparent stranger, going to an unknown destination. If you are going to a medical appointment, you will need to calm her by speaking soothingly, and telling her you are taking her to see her doctor. Otherwise, it may be best to take her home as soon as possible, if you cannot reassure her.

The important thing, when your mother is alarmed, is to keep calm yourself. If you become anxious and upset you will escalate her fear. Be reassuring, soothing, and try to distract her with something; change the subject of the conversation, or suggest a stop at the ice cream shop after the appointment. Remember how you used to distract your children? Well, you may have to do that with Mom. But still give her the respect due an adult.

Do not say, “Mom, I’m your daughter, Ann. Don’t you remember me?” Only state the fact, “Mom, I’m your daughter, Ann. I am taking you to Dr. Smith for your check up.” If she insists that she doesn’t have a daughter, don’t argue with her. She may be in the past, in a time before she had children. Go along with her reality as much as possible. Don’t consider it lying, consider it time travel; you might discover some treasures from the past.

Be sure to take the same familiar routes every time you take her out, whenever possible. Take her to restaurants and stores that she knows. You might want to use her car, if she has insisted on keeping it. (I hope you have all the keys!) Keep everything as familiar and routine as possible.

Confusion After Hospital Stay

2009-03-31T13:05:00.000-07:00

Another sample question and answer.

Q.

I think my Mom has dementia. She has been very confused since she came home from the hospital for a urinary tract infection. She doesn’t always know where she is, or she forgets to take her medications, or takes them at the wrong time.

A.

This may or may not be permanent dementia. Your mother’s body and brain have been assaulted by several factors: the infection, the antibiotics, any change in prescriptions, a change in her routine and her surroundings when she entered the hospital, a change in her diet at the hospital.

An elder’s brain functions more slowly and recovers slowly from these insults. It may take months to recover. Or the dementia may be permanent.

Keep a written record of her symptoms. Date when you observe each symptom. Be specific. Instead of writing, “Mom was very confused today.” Write, “Mom thought I was her sister.” “Mom took her morning meds in the evening while leaving her evening meds untouched.” “Mom tried to open the front door with the garage door opener. She thinks the batteries are dead in the garage door opener.”

This log will be useful for a couple of reasons. You can give a copy of the log to your mother’s physician and ask him if she has dementia. This log may also be used in court should you need to ask for guardianship in the event the dementia is permanent.

Be sure to set up your mother’s medication in a pill box to simplify the process for her. You may want to telephone daily to ask her if she has taken her meds. Or you might want to install an automatic medication dispenser, if she is very confused. A home care agency can also send a caregiver to monitor your mother’s meds, provide her with a meal and some housekeeping, as well as shower assistance and companionship when you can’t be there.

Refusing Caregiver Services

2009-03-31T13:03:00.000-07:00

Another sample question and answer.

Q.

My mother who is 78 is the caregiver for my father who is 85 and has had a stroke. Her health is not good and she is worn out. She wants to hire some outside help but my father says he won’t have a stranger in the house. How do I convince Dad that Mom needs help too?

A.

To start with you may have a generational attitude that the husband’s will is law, and the wife is more of a servant than an equal. Even among loving couples this attitude may be there to some extent. It may mean that a wife has had a lifetime of thinking that she does not have a right to insist on her needs being met.

Whatever the cause, you and your mother need to stand up to your father and gently but firmly make it clear to him that he must allow that “stranger” to come in. The time for him to make this choice is past. If your mother is unable to do this for herself, you and your siblings, a minister, or respected friend may be able to do this for her.

The arguement would be approximately this. "Dad, you need to know that Mom’s health is failing. She can no longer provide all of your care. If she ends up in the hospital, there will be no one to take care of you. You would have to move into a nursing home while she is hospitalized. At her age, the hospitalization could result in a lengthy nursing home stay. Which means you will be much more likely to be permanently institutionalized. I know you want to stay home with Mom. The only way that is possible is to bring in some extra help. I’ll give you two days to think about it, but it is going to happen, Mom can no longer do it."

Confusion Over Paying The Bills

2009-03-31T12:54:00.000-07:00

Another sample question and answer.

Q.

My father is increasingly confused by the bills he receives and is sure he is being overcharged at times for services he did not receive. When I have gone over his bills with the company involved, I find that he did receive those services but has refused to pay the bill. I cannot convince my father that he needs to pay the bill. He insists he is right and the company is wrong.

A.

We run into this quite often when billing for our services. As we age, our minds think more slowly and more concretely. We are no longer able to read between the lines, but understand only what we see in black and white. Making inferences between invoices and a monthly statement may be difficult.

You may need to draw lines, on a statement, from invoice billed to invoice paid. Or you might lay them all out on the table and go through them one by one with your father. This takes time and patience.

To relieve both of you of what will become an increasing problem, you may want to help your father set up a service with his bank to review and pay his bills for him. This is not that same as automatic bill payments. It is a personal banking service that can be a help to seniors and people with low vision.

On the other hand, you may want your father to keep his mind working at his usual mental tasks as long as possible. However, if he is becoming frustrated and angry, and you are as well, it may be time to look to the bank for help, or take over your father’s bill payments yourself.

Mom Refuses Help

2009-03-31T12:41:00.000-07:00

We will start with some sample Q & A’s to get started. Feel free to ask for more clarification of any subjects.

Q.

My Mom, who is 80 years, keeps insisting that she can’t afford to pay for any help. She is always asking family and neighbors for help with transportation and housekeeping, but she does not want to reimburse anyone for the help she receives, saying that she can’t afford to pay anything more than an expression of thanks. She acts as if that is her right, especially from family members. I am quite sure she has enough money, since Dad left her quite well off before he died, but I don’t really know, since she won’t let me look into her financial situation.

A.

There is more than one issue here, so let’s take them one at a time. Her beliefs are: I can’t afford it. I have the right to receive help from younger generations. I am not going to let anyone take over my life or my finances. Your questions are: Exactly what is her financial situation? How do I get her to pay for outside help?

"I can’t afford it."

This may or may not be true. You do not know if your mother has spent the money your Dad left. She may have given large financial gifts to grandchildren, or spent money on clothes and vacations. Then again she may have saved most of it. But did the investments go sour? Or did an unscrupulous family member or “friend” manipulate her into giving her money to him?

If she does not have a financial advisor, encourage her to get one. The financial advisor can at least tell her what she can afford, but she may not be able to convince her to accept formal home care services.

Our oldest Seniors have trouble changing a lifelong habit of saving their money. To switch from saving for the future to spending for the present is a big switch in a lifelong thinking pattern. The elderly do not change these patterns easily. Give your mother time to think about the change you are asking her to make.

She may be be afraid that she has to stretch her money to age 100 or more. Maybe you need to discuss what is a realistic life span for her.

You may also want to point out that she may need to spend money to save money. Spending some money on home care may avoid bigger bills for hospitalization. Statistics show that a little home care can significantly reduce hospitalizaton and institutionalization of the elderly. We do have an information sheet about this, that you can download, Getting Your Money’s Worth.

Maybe she wants to save her money to pass on to heirs. If that heir is you and you are her family caregiver, you may point out that the inheritance could very well be spent on your medical bills as a result of your exhausted health. Overworked family caregivers often have medical problems and shortened life spans as a result of their caregiving duties. Gently let her know that you do not want such a future for yourself. She likely does not want to be a burden on you, so take advantage of that to suggest a home care service.

"I have the right to receive help from younger generations."

Some seniors have a sense of entitlement. They have worked hard and now they expect to be served by their younger family members and neighbors. They can be quite charming in how they ask for help, or they can be very demanding. Some become skilled at convincing younger people to help them. Since they can get help for free, why should they pay for it?

Those who are helping them may need to make it clear what each person’s limits are when it comes to helping. If one person has completely reached the end of his rope, he needs to make it clear that he can no longer help, and urge the senior to engage the services of a home care agency. It can be hard to refuse the next call for help that one receives after taking this stand, but doing so will provide an incentive for the senior to do what is necessary.

"I am not going to let anyone take over my life or my finances."

There is a huge fear, among our seniors, that younger people may want to take away their freedom and independence. You may need to reassure your mom that you want what she wants, which is to stay home as long as possible. Discuss ways that will make it easier for both of you to help her stay home. Accepting home care services will help her and ease your burden. Using the services of a financial advisor can keep her in control of her finances.

Our Qualifications

2009-03-31T12:33:00.000-07:00

Our office staff has 20 combined years of experience working in home based elder care. Nancy Aley is a Licensed Master Social Worker who has worked with Comfort Keepers for 4 years and has family caregiving experience. Sandy Tisnado is a Licensed Practical Nurse and has worked with Comfort Keepers for 3 years. Esther Rullan has coursework in business administration and has worked for Comfort Keepers in Sierra Vista and Roswell for 7 years. Sandra Chancellor has family caregiving experience, an A.A.S. in Dental Assisting, and has worked with Comfort Keepers for 6 years.