Officials, Schools Prod Doctors to Focus on Elderly Care
Mary Boland, 91, can consider herself fortunate. In 2006, the chronically ill former teacher from Cincinnati had a narrow brush with death when she came down with pneumonia. Within minutes, Boland's personal physician, Gregg Warshaw, was called.
"She was weak, confused and breathing abnormally," Warshaw recalls. "Her blood oxygen level was low, and she was suffering a low-grade fever."
In the elderly, pneumonia is often fatal. But instead of rushing Boland to the nearest hospital, as many family doctors might have done, Warshaw, a geriatrician, stabilized the condition and put his patient on antibiotics.
"Luckily, the pneumonia wasn't grave enough to warrant hospitalization," Warshaw says.
Geriatricians have provided specialized care to the elderly for decades, and until recently their numbers have been growing. But despite countless attempts to convince the medical profession and the public of their worth, the number of practicing geriatricians in the United States -- about 7,000 -- is falling seriously behind needed levels.
While the U.S. population age 55 and older is growing rapidly, according to a 2005 census report, the number of medical school grads going into geriatrics has been slow to keep up.
According to one estimate, the nation's teaching hospitals are producing one or two geriatricians for every nine cardiologists or orthopedic surgeons.
Read Entire Story Here
Monday, March 31, 2008
Sunday, March 30, 2008
Florida's Elder Care System Backs Up
ORLANDO, Fla. (AP) - Caring for the elderly is one of Florida's growth industries - nearly a quarter of the state's population is over 60 and almost 10 percent is at least 75.
But caring for the poor among them is a different story - particularly when a patient becomes unable to make his or her own decisions.
To take care of them, Florida, like many states, has a public guardianship system - a government entity that works through the courts to appoint guardians for those without the means to pay for their own.
But it's a skeleton entity, and only about half of Florida's 67 counties are covered. And even in those, there's a waiting list of seniors - 254 people, according to the most recent figures from the Statewide Public Guardianship Office. That was up from 225 in the office's 2007 annual report and 132 people waiting in 2006.
Even then, that might just be a fraction of the problem — the state public guardian estimated in 2004 that 5,000 to 10,000 people who needed its services weren't getting them. That population of endangered adults is expected to rise as more baby boomers age and head here for retirement.
Terry Hammond, a Texas attorney who also serves as executive director of the Pennsylvania-based National Guardianship Association, estimated fewer than 25 states have a public guardian program at all. Florida is ahead of those without one, he said, but barely. Without broad legislative support, it amounts to an unfunded mandate that raises equal protection concerns, he said.
Hammond said he knew of only one other state, New Mexico, with a waiting list for public guardians.
"The question ultimately is, 'What are we willing to pay in human cost to save money for the budget?"' Hammond said. "And if the government isn't willing to spend money on people who need assistance, what is the purpose of that government?"
A guardian is essentially a surrogate decision-maker, appointed by a judge after someone is found incompetent to care for him or herself. To qualify for public help, a person must have limited means and no family or friends willing or able to provide care.
"It's really the office of last resort for the most vulnerable of the vulnerable," said Michelle Hollister, executive director of the SPGO. "They're incapacitated, they have no money and they're basically alone."
Florida does have its success stories.
In 2006, a 69-year-old from Immokalee was suffering potentially fatal septic shock while his wife was out of the country. An emergency guardian was appointed, approved treatment and the man recovered.
A 63-year-old woman with dementia and mild retardation was saved from an abusive caregiver after an Adult Protective Services investigator found her hiding in some bushes. She was appointed a public caregiver and placed in a safe home.
But cases must be referred into the system, and that only happens if someone thinks an individual is exhibiting signs of incapacity. Because the state's wards are by definition alone, the first call often isn't made.
Florida's public guardian system is also chronically underfunded, relying on a county-by-county melange of charities, partnerships and sheer good will.
Some, like the Guardianship Program of Dade County, are almost entirely funded by the county. Others, like the Fifth Circuit Public Guardian Corp., which serves Marion County, rely heavily on the United Way, despite being a "public" agency.
The localities with waiting lists can't simply accept an additional ward or two, because state law limits how many people each guardian can have.
The SPGO is asking for a $1.3 million increase over its roughly $2.3 million budget this year, which would enable it to care for an extra 150 people. It isn't even trying to get the estimated $24 million it would take annually to serve everyone who needs help.
The most severe cases can be taken on by Adult Protective Services, but there are real effects of the waiting list limbo. Perhaps the most tangible is higher public health care costs, because hospitals must keep some patients until the system can accept them.
"As long as we know that they're taken care of," said Andrea Wolfkill, a case manager in Marion County. "If they're in a facility, I don't move as quickly — if they're in a hospital. They've had people two or three months because they don't have a guardian."
That problem — and expense — prompted Martin Memorial Health Systems in Stuart to initiate its own public guardian program for Martin County. Linda Hake, a senior attorney for the hospital who now oversees the program, said she had been trying since 1999 to start a public entity. It opened in 2006, with no county funding.
"Trying to find guardians for people who have no money is impossible," Hake said. "And those are the people that need them, because they're the ones typically that don't have the family resources. They're estranged from their family, they're alcoholics."
But caring for the poor among them is a different story - particularly when a patient becomes unable to make his or her own decisions.
To take care of them, Florida, like many states, has a public guardianship system - a government entity that works through the courts to appoint guardians for those without the means to pay for their own.
But it's a skeleton entity, and only about half of Florida's 67 counties are covered. And even in those, there's a waiting list of seniors - 254 people, according to the most recent figures from the Statewide Public Guardianship Office. That was up from 225 in the office's 2007 annual report and 132 people waiting in 2006.
Even then, that might just be a fraction of the problem — the state public guardian estimated in 2004 that 5,000 to 10,000 people who needed its services weren't getting them. That population of endangered adults is expected to rise as more baby boomers age and head here for retirement.
Terry Hammond, a Texas attorney who also serves as executive director of the Pennsylvania-based National Guardianship Association, estimated fewer than 25 states have a public guardian program at all. Florida is ahead of those without one, he said, but barely. Without broad legislative support, it amounts to an unfunded mandate that raises equal protection concerns, he said.
Hammond said he knew of only one other state, New Mexico, with a waiting list for public guardians.
"The question ultimately is, 'What are we willing to pay in human cost to save money for the budget?"' Hammond said. "And if the government isn't willing to spend money on people who need assistance, what is the purpose of that government?"
A guardian is essentially a surrogate decision-maker, appointed by a judge after someone is found incompetent to care for him or herself. To qualify for public help, a person must have limited means and no family or friends willing or able to provide care.
"It's really the office of last resort for the most vulnerable of the vulnerable," said Michelle Hollister, executive director of the SPGO. "They're incapacitated, they have no money and they're basically alone."
Florida does have its success stories.
In 2006, a 69-year-old from Immokalee was suffering potentially fatal septic shock while his wife was out of the country. An emergency guardian was appointed, approved treatment and the man recovered.
A 63-year-old woman with dementia and mild retardation was saved from an abusive caregiver after an Adult Protective Services investigator found her hiding in some bushes. She was appointed a public caregiver and placed in a safe home.
But cases must be referred into the system, and that only happens if someone thinks an individual is exhibiting signs of incapacity. Because the state's wards are by definition alone, the first call often isn't made.
Florida's public guardian system is also chronically underfunded, relying on a county-by-county melange of charities, partnerships and sheer good will.
Some, like the Guardianship Program of Dade County, are almost entirely funded by the county. Others, like the Fifth Circuit Public Guardian Corp., which serves Marion County, rely heavily on the United Way, despite being a "public" agency.
The localities with waiting lists can't simply accept an additional ward or two, because state law limits how many people each guardian can have.
The SPGO is asking for a $1.3 million increase over its roughly $2.3 million budget this year, which would enable it to care for an extra 150 people. It isn't even trying to get the estimated $24 million it would take annually to serve everyone who needs help.
The most severe cases can be taken on by Adult Protective Services, but there are real effects of the waiting list limbo. Perhaps the most tangible is higher public health care costs, because hospitals must keep some patients until the system can accept them.
"As long as we know that they're taken care of," said Andrea Wolfkill, a case manager in Marion County. "If they're in a facility, I don't move as quickly — if they're in a hospital. They've had people two or three months because they don't have a guardian."
That problem — and expense — prompted Martin Memorial Health Systems in Stuart to initiate its own public guardian program for Martin County. Linda Hake, a senior attorney for the hospital who now oversees the program, said she had been trying since 1999 to start a public entity. It opened in 2006, with no county funding.
"Trying to find guardians for people who have no money is impossible," Hake said. "And those are the people that need them, because they're the ones typically that don't have the family resources. They're estranged from their family, they're alcoholics."
Saturday, March 29, 2008
Long Term Care Aims to Feel More Like Home
We found the following article useful in that it depicts many of the same philosophies we hold regarding senior and elder care in a home setting.
Monday, March 17, 2008
A nursing home in Jefferson County and a Knoxville architectural firm are in the forefront of a reform movement aimed at taking long-term care out of institutionalized settings.
Jefferson County Nursing Home is adding three long-term care facilities slightly larger than traditional homes, each with private bedrooms and baths arranged around a hearth room, and a large dining table where residents and staff can gather for meals. The homes are designed to offer elders vibrant communities, with sun-filled rooms and a garden to explore, rather than institutions with long halls and sterile environments.
Read the Entire Article HereWhat makes a Green House?
- Architecture: Resembles nearby housing, ranging from single-family homes to high-rise apartment buildings. Private bedrooms and bathrooms, open hearth, dining and kitchen areas, ceiling lifts and fenced yard. Materials and design emphasize home-like setting.
- Staffing: caregivers provide personal care, meal planning and preparation, light housekeeping, and laundry. A guide serves as a coach and supervisor and might serve one or more homes. Nurses enter and work in the homes much like they would in a home health care setting.
- Interior design: Residents may bring some of their own furniture and accessories. A large dining table seats staff and residents together for meals. Bedrooms open to the central hearth area.
- Size: Intentionally small, housing 6-10 people in 6,000-7,000 square feet.
- Lifestyle: Less scheduled, more privacy and more control of their daily activities than a traditional setting.
- Relationships: Social interaction is key, and friendship between caregivers and residents is encouraged. Families, children, pets and volunteers are welcome guests.
Monday, March 24, 2008
Is Crisis Looming for Elder Care in Hawaii?
Crisis coming in elder care, AARP warns
Residents pessimistic about health care in state
The number of people age 65 and older in Hawaii is expected to grow by 86 percent between now and 2030.
So says a survey by AARP Hawaii, which urges prompt action to avoid a crisis in long-term care for seniors.
"If nothing is done in the very near future, like right now, to begin addressing these issues in a substantive, systematic way, we're going to find ourselves with an essentially insolvable problem," said Bruce Bottorff, AARP Hawaii associate state director.
AARP Hawaii is urging the Legislature to pass Senate Bill 3255 with $250,000 to create a commission that would determine resources needed to meet long-term care policy goals.
Read Full Story Here
Residents pessimistic about health care in state
The number of people age 65 and older in Hawaii is expected to grow by 86 percent between now and 2030.
So says a survey by AARP Hawaii, which urges prompt action to avoid a crisis in long-term care for seniors.
"If nothing is done in the very near future, like right now, to begin addressing these issues in a substantive, systematic way, we're going to find ourselves with an essentially insolvable problem," said Bruce Bottorff, AARP Hawaii associate state director.
AARP Hawaii is urging the Legislature to pass Senate Bill 3255 with $250,000 to create a commission that would determine resources needed to meet long-term care policy goals.
Read Full Story Here
Sunday, March 23, 2008
Images From Kelso House AFC
We thought we should share some photographs taken during the past several months here at Kelso House. Enjoy!
Retired Racers Make Great Senior Companions
NORWALK — A retired racing greyhound’s life took a fortunate turn when she was adopted by the Norwalk Memorial Home last month.
Lexi, the 2-year-old greyhound, was actually adopted by more than 50 residents of the skilled-nursing facility at 272 Benedict Ave., according to Johnna Young and Nancy Nickoli, spokeswomen for Fisher-Titus Medical Center.
There are 54 long-term residents at the facility and many of whom have become ”enthralled” with the rescue dog since her arrival.
When Nickoli, director of the volunteers and activities at the nursing home, began searching for a replacement therapy dog for one that had died last year, she began familiarizing herself with greyhounds, she said.
We have a Retired Racer at Kelso House AFCThey DO Make Good Senior Companions!
Let's Talk About the Weather
February 11th, 2008
Kelso House Adult Foster Care is in Northern Michigan, and this time of year can bring some pretty extreme weather conditions to our area. For example, the past two days saw temperatures around -20 degrees Fahrenheit — NOT counting the wind chill. And it WAS windy.
To add to these conditions, the electric power was knocked out for about 2 hours last night. This was right during dinner, so out come the candles. Northern Michigan Adult Foster Care Tip Number One: keep plenty of candles around. Know where a working flashlight is, and know where to find matches or a lighter for just such emergencies.
We have a gas furnace - but, it needs electricity for the thermostat to even kick the furnace on. We finished our dinner by candlelight, then all stayed in one room and wrapped up for the duration. Northern Michgan Adult Foster Care Tip Number Two: have plenty of extra blankets on hand - comforters and feather beds are the best.
Ailie and my wife curled up on the large sofa together with two large blankets over them to stay good and warm, and I got under the feather bed on a smaller sofa and read a book by candlelight.
Kelso House Adult Foster Care is well-insulated and the heat conserved well. It has crossed my mind a few times to have a back up generator. This is not a bad idea. On the other hand, we have been here for over 8 years now, and the electricity has never been out for more than a few hours. This time was no exception. Ailie had actually fallen asleep, when the lights popped back on and the smoke alarms started beeping around 9 pm and roused us all.
Even when the electricity is fully operational, keeping elderly clients warm in rough winter weather is of primary concern. A blanket is kept over them at all times - even while watching television on the cushy sofa. At night, the temperature always drops a little more, and keeping our clients warm in bed is very important. Northern Michigan Adult Foster Care Tip Number Three: Ailie’s bed is equipped with a heated mattress pad, which we keep at a low heat during the night, and she reports that this keeps her very warm and cozy.
Remember that your clients may not always voice their needs to you. You must always be thinking of their needs and asking them if they need such things as blankets while they are sitting on the sofa, for instance. Better yet - just bring it to them, and they will most likely use it once they see it in front of them.
In Northern Michigan, just when you think winter is letting up - that’s when it always can catch you off guard. Be prepared - stock up on batteries - know where to find flashlights and lighters and matches. Keep heavy blanket and comforters handy. And always try to anticipate your aged clients’ needs before they need to ask.
Hoping the rest of YOUR winter is safe and warm,
Kelso House - a Northern Michigan Adult Foster Care Home for the Aged.
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