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In-Home Care Criminals

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Recently an investigative reporter for the Times Sacramento Bureau Chief Evan Halper uncovered that violent felons have been permitted to enter the homes of the frail and sick to perform healthcare services. Is this an incendiary story with little statistical significance designed to give the Governor an excuse to cut the In Home Supportive Services Program (“IHSS”)? Or is it a horrifying reality of an industry fraught with problems such as high stress, relatively low wage positions?

IHSS, is intended to provide an alternative to nursing homes for low-income residents. Here in California, one must qualify for Medi-Cal in order to receive this benefit which is 283 hours a month.

According to Halper, individuals convicted of crimes such as rape, elder abuse and assault with a deadly weapon are permitted to care for some of California’s most vulnerable residents as part of the government’s home health aide program. The facts:

  1. Data provided by state officials show that at least 210 workers and applicants flagged by investigators as unsuitable to work in the program are nonetheless scheduled to resume or begin employment. Current rules allow California to hire convicts, and privacy laws often keep patients in the dark about their caregiver’s past. Simply stated, thousands of current workers have had no background checks.
  2. A court ruling earlier this year that said only specific types of child or elder abuse or fraud disqualify a person from being a caregiver in the state’s In Home Supportive Services. As a result, people convicted of crimes such as rape and assault with a deadly weapon have been permitted to provide care.
  3. The 210 providers alleged to be dangerous felons with convictions represent 0.00005 percent of the 380,000 homecare providers in IHSS.
  4. Many homecare providers are family members or friends.
  5. If this program is cut, many older poor frail adults will have no assistance with daily tasks critical to thriving such as eating, bathing, walking, toileting, etc.
  6. The budget was initially passed by the state assembly and senate last week and was approved by Governor Arnold Schwarzenegger the same day. Schwarzenegger implemented nearly $1 billion in additional spending cuts by exercising his line item veto power. He cut $300 million cut from In-Home Care.

I don’t usually believe in conspiracy theories, but here’s a question. If our legislature truly cared for the sick and disabled, wouldn’t he keep the program alive and put in place systems to ensure that this population can safely age in place instead of killing it?

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“Raising UP Your Parents” seminar update

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Seminar Update:

The seminar at the Hotel Huntington Beach went very well. I am grateful for the panel and their expertise. For those of you who missed it or couldn’t find the Hotel Huntington Beach, this is what you missed.

First, in an effort to figure out whether or not it is safe to age in place, we explored some assistive technology. The CapTel phone was introduced. This device has streaming captions of the conversation a relatively big screen. There are some public benefits that enable you to get this for free. If you want to know more about his just click on the CapTel icon on my homepage. Jay’s Hearing is a fixture in Long Beach and Orange County. He has been in business for many years and he is truly an expert in assessing hearing loss and finding solutions to hearing deficits.

We had a doctor talking about fall prevention, in short, his advice get in shape and keep in shape.   NuVision also had some great technology for the vision impaired. I highly recommend checking them out if you know someone who has any type of vision loss and is looking for a solution.

Monica Bush from ResCare discussed what to look for when hiring an in home caregiver.  ResCare has some great technology available as well. They have a device that enables a family to watch what is going on in the home. You can just click on their icon to see more. HomeWatch Caregivers of Huntington Beach was also there. The owner of that facility used to be a fire fighter and is very dedicated to the health and safety of our citizens!

In the spirit of aging in place there was an in home dental company. How cool that they will go to your home or your parents home with before and after pictures to quell any suspicion that this service is too good to be true. They are called homecaredentists.com Google them!

Oxford Home Health discussed how one can qualify for in home health care under Medicare as well as how Oxford has been in business with the same owner since the 1960’s.   Oxford can be contacted by clicking on their icon. Greater Newport Physicians was also there. This medical group provides services to a wide range of people in Orange County.

Huntington Terrace Assisted Living was there. It is a beautiful, three-story community situated on three acres of meticulously landscaped grounds and gardens. I toured this facility and it is very nice especially with the renovation.

A representative from The Covington of Aliso Viejo shared information about this Continuing Care Retirement Community. A CCRC offers a broad spectrum of care and services to foster good health, fulfillment, and spiritual well-being in the lives of older adults. The Covington offers three levels of care: Independent Living, Assisted Living, and Skilled Nursing. In addition, The Covington also provides care for those with memory impairments in The Courtyard. A CCRC reduces the likelihood of relocation stress syndrome which can and does affect an older adult’s often delicate psyche.

This is a short list of items covered and experts involved in my last seminar. There will be an expert on dementia care at my next seminar on Saturday October 23, 2010 in Irvine at the Hilton as well as an expert on public benefits, MRS Specialists. It is a do not miss. I hope to see you there!

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The Magnificent Mrs. MB, Part 2

Within 5 days of delivering the report, Mrs. B asked me to come to her home. She was shadowed by another woman who she sponsored at AA and who was there at our first meeting. We will call this woman, her shadow. At first I was suspicious. It is not just that I have an inherently distrustful nature, it is that I have seen these types linger around frail older adults with assets many times and THEY HAVE DONE BAD THINGS TO MY CLIENTS. In time, I came to not only trust the shadow, but because Mrs. B’s daughters were out of the country, I came to rely on her for doing the things that a daughter would do.

When I arrived, Mrs. B was sitting up in her bed upstairs eating a peanut butter and lettuce sandwich.  Because she had to sleep in an upright position, she developed stenosis. She complained of pain. Overall she seemed determined and strong. Mrs. B again reiterated her desire to move her husband elsewhere and the conflict she felt about “institutionalizing” him. The consensus was that she would tour a facility by her home that I recommended. I asked her to articulate her wish list, and certainly regaining her strength was primary. However, it was clear that her mental attitude was an impediment, so we discussed anti-depressants. Being the stoic person that she was, she had stopped taking them.

I spoke with Mr. B, he was bored. Every day that I spoke with him he said he was bored. He had very bad hygiene, could not make his own meals, pick his clothes out or do his own laundry. I came to feel that placing him was the right and kind thing to do. He sat and sat and sat all day without any social interaction.

We had a plan. Mrs. B. would tour the assisted living facility the following Monday. By the time I left, she was up and about and demonstrating her new lift. She looked happy and hopeful. The next Monday when I met her at the facility, she looked like she was knocking on death’s door.

What happened? I kept asking myself this question. Just two days before it seemed like you could swim in her eyes. When I saw her that Monday, she did not look spry and her lids were heavy over her big blues. She could barely get out of the car and I needed to get wheelchair assistance.  She had fallen the night before. There was no one there to help her.

The next morning I got phone call after phone call from one of her many friends “Mrs. B… keeps saying she is dying and she won’t let us take her to the hospital or the doctor.” I rushed back from my appointments and cancelled my day. Both she and her husband had fallen the night before and this time she was in terrible pain and scared. He was oblivious. She could barely breath.  She was gagging on her coughs.

I gave her two choices I would either bring her to the hospital or I bring a doctor to her. She told this doctor, (a geriatric concierge medical doctor who did her residency in geriatrics) was accused of being a quack while conducting a bedside examination and dismissed her. Now what?

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Video: Did In Home Care Work Out?

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Episode #002 – In-home care is a great solution for those who want to age in place.  Professor Rose’s stepfather did not want to go to an assisted living facility.

For the complete Mike Rose Series, click here.

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Not Taking Your MEDS…Can Be Expensive!

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Raise your hand if you think that you should buy a worthless piece of property for $50,000 off an infomercial. Well if you are 85 years old, live alone and forget to take critical medication than the answer is, I guess.

That is precisely what a client’s father did this year. That was just a couple of days before he went into the hospital because of severe dehydration. Thereafter, he ended up in a nursing home to rehabilitate for three weeks.

When he got home and learned of his shopping spree, he was outraged and in complete denial. There was just no way that this fiscally responsible man would have done that.

Ahhh, those pesky IADLs (Instrumental Activities of Daily Living)—medication management, what a drag. This gentleman is on seven medications all of which have to be taken at different times throughout the day.

How could this have been avoided? Continue reading Not Taking Your MEDS…Can Be Expensive!

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