Wisconsin A Leader In Pressure Ulcer Initiatives

from Medical news Today:

The Wisconsin Department of Health Services announces that health care
leaders from across the state have formed the Wisconsin Pressure Ulcer
Coalition to help reduce pressure ulcers in Wisconsin's health care
industry, including nursing homes and hospitals.....

The goals of the Wisconsin Pressure Ulcer Coalition are to:


- Decrease the incidence of pressure ulcers in our health care settings

- Continue to educate caregivers and leaders about effective preventive measures

- Improve assessment when an individual is admitted to a health care facility, as well as continue to monitor appropriately

- Develop appropriate prevention strategies within 24 hours if
individual identified to be at risk of developing pressure ulcers

- Improve communication between providers to provide a better continuity of care

for More...

Newspaper Explores LTC Crisis in own Backyard

from PHI:

As the challenge of caring for America’s aging population
intensifies, the issue is beginning to get the increased newspaper
coverage it deserves. Case in point: an in-depth series that has been
offered up from a small daily paper out of Utah (hat tip to The New Old Age).

Gray Area: Utah As It Ages
features sparsely written vignettes examining the lives of elderly
people in Utah when they were young and their current challenges with
aging. Accompanying each story are intimate black and white photos of
wrinkles, smiles, and struggles.

For More...

LETTER OF SUPPORT FOR UNITED CAREGIVERS OF AMERICA

from Gather:

As I write these words thousands upon thousands of elderly people
are being cared for at home, in hospitals, and nursing homes. The
problem is most caregivers lack the proper amount of training and
education to deliver or administer top of the line quality care and
treatment. The nurse aide, home health aide, and family member
caregiver need to be recognized as the most important component in the
long term health care system. They are the ones who make or break the
system. They are the ones who deliver the majority of care to the
patient. Yet they are the ones least recognized and in some cases even
disrespected.

At some point in time all of you reading these
words will be face to face with a basic caregiver. And you better hope,
for your sake, they know what they are doing. For they are the ones who
hold the key to your survival. They are the ones in control of your
care. And in many cases they will be the ones fighting for your life
(or not). How do you know a good caregiver from a bad caregiver? You
don't.

For More......

Care and support - a community responsibility?

from Joseph Rowntree Foundation:

Any new settlement on long-term care and support must address the apportionment of responsibility for its delivery as well as its funding. With the state's capacity limited and family input likely to decline, the wider community must expect to play a growing role. This offers an opportunity to end social care's marginalisation, argues David Brindle.

Author
David Brindle, The Guardian
Key points

    * Social care has become isolated from mainstream society and its recipients are cut off from their neighbourhoods and from each other.

For More......

Disabled people 'bullied at work'

from guardian.co.uk:

Disabled people are much more likely than the able-bodied to be hit,
injured, bullied and humiliated at work, groundbreaking research for
the Equality and Human Rights Commission will reveal today.

In
the first comprehensive survey of discrimination in the workplace, the
commission found 11.6% of employees with a disability or long-term
illness experienced physical violence at work, compared with 5.5% of
other employees.

It said 8.8% of disabled people sustained an
injury as a result of violence or aggression at work, compared with
4.7% of able-bodied people.

For More.....

Nursing Home Litigation

from InjuryBoard.com:

My, My!!

Nursing home cases in Arkansas present unique problems. Many nursing
homes no longer carry liability insurance and have mortgages and liens
against their assets, making collection of any judgment next to
impossible. After a series of large verdicts here in Arkansas the homes
could no longer afford to carry liability insurance.

My advice in selecting a nursing home for your loved one is to inquire
about their history of lawsuits in the past. One good source is the
Medicare website, Nursing Homes Compare.

New Internet Service Delivers Relief to Families of Those in Long-Term Care

from International Business Times:

COLUMBUS,
Ohio and PHOENIX, Nov. 25 /PRNewswire/ -- There is a newInternet
service available that changes the communication paradigm inlong-term
care. Addressing the family's basic need to stay informed, it
allowslong-term care providers to give them regular proactive wellness
updatesthrough a secure web page, by email and text message without
families havingto call, no matter where they are.

Too much to do and too little time. It's a common problem that takes
onspecial significance for the families of the more than 3.8 million
people inthe U.S. living in Nursing Homes, Assisted Living Facilities
or receiving HomeCare as they struggle to stay up-to-date with the
well-being and needs oftheir loved ones.



"As one of the millions of people in the U.S. with family in
long-termcare," said Neil Moore, founder and chief executive officer
ofConnect4Healthcare, the company that developed the service, "I was
shocked tofind that with all of the technology available to us today,
the only way wecould find out how our loved-ones were doing was to
visit or call the careprovider. Most of us can't do that as often as we
want; our lives are just toohectic."



After spending almost 20 years in the healthcare IT business, Moore
knewhe could do better. "That's why we created Connect for
Healthcare(TM). It'sbecome my personal mission. We (families) want and
need the information; carefor our loved ones is better when we are
better informed, and good careproviders want to communicate with us. It
helps everybody involved."



The Connect for Healthcare(TM) service was developed by the company
withinput from families and care providers. "Although our primary
objective is tohelp families and their loved ones," says Moore, "the
role of the long-termcare provider in our process is critical. Staff
time and money continue to betheir key challenges. The simplicity of
our software and our unique businessmodel address them both."



Today, the company is introducing their service to long-term
careproviders but plans to begin marketing directly to consumers early
next year."In the meantime," says Moore, "families that want the
service should call thecare provider and ask for it. Send them to our
website or have them contactus. We can have them ready to start sending
you updates in less than a day."

Nursing home suicide rates have not improved in 15 years

from McKnight's:

While instances of suicide among community-dwelling seniors have fallen
in recent years,the same has not been true for long-term care
residents, according to a recent study.



University of Michigan researchers studied the rate of suicide among
seniors aged 60 and over in New York City between 1990 and 2005. During
that time, the relative rate of nursing home suicides did not decline.
The most at-risk cohort were men between the ages of 60 and 69.

Storytelling in Long Term Care Facilities

from Novice to Expert:

This article really resonated with me. I truly believe in the value of
storytelling and if stories carried actual physical weight, I would
weigh a lot more than I did when I first started in nursing because of
the patients' stories I carry with me.

This article from Provider Magazine, Creative Tasks Spark Imagination,
outlines three techniques used in a long term care facility for
residents along the continuum of memory impairments (from none to
late-stage Alzheimer's or dementia). The first technique is based on Timeslips, which promotes social interaction. It helps to reduce the isolation that many persons with dementia may experience.

The second technique involves storyboarding which can be done by the resident or by the family, if the resident is not able to participate. Upon completion of the storyboard, a celebration is held to celebrate the individual's life.

In the third technique, individuals write their life stories in a 6-10 week storytelling workshop.

Disabled couple see independence intertwined with will to live

from The Sacramento Bee:

Kevin Terrell and Beverly Evans-Terrell are married. They live in an
apartment in the Country Club neighborhood of suburban Sacramento. They
have both been disabled since birth and depend on services provided
through the state to remain independent and live outside of nursing
homes.

Kevin Terrel

I grew up in a nursing home in Southern California. Nursing homes are a zoo.

You live with at least 50 other people and you have 50 people working
in various positions. I don't like them. I am the king of
claustrophobia. I need my space. I need my privacy. I will not go back
to a nursing home without a fight. It's not going to happen.

If nursing homes cost so much, why is California trying to cut these
programs that do their best to keep us out of nursing homes? That is
what I would like to know.

Beverly Evans-Terrel

I was born with spina bifida. I was raised at home until I was 13 and
then I lived in Sonoma State Hospital. When I was 24 I asked to be
placed in a place where they would teach us to be somewhat independent.
Now I live on my own, with Kevin.

If we have to go back to nursing homes we will lose the will to live.
Living on my own I have the responsibility to take care of myself. I'm
free from dictators. I can go anywhere I want to go. I can go to bed
when I want to.

In Housing Slump, Elderly Forgo Assisted Living

from The New York Times:

Maybe a reason for more in-home supports!

The housing crisis has kept thousands of older Americans who need
support and care from moving into retirement communities or
assisted-living centers, effectively stranding them in their own homes.

Without selling their houses or condominiums, many cannot buy into
retirement homes that require a payment of $100,000 to $500,000 just to
move in. So they are scratching themselves off waiting lists, canceling
plans with packing services and staying put, in houses that fit well 30
years ago, but over the years have become lonely, too large or too
treacherous to navigate.

National Senior and Disability Advocates Agree on Principles for Financing Long-Term Services and Supports

from MarketWatch:

WASHINGTON, Nov 20, 2008 /PRNewswire-USNewswire via COMTEX/ --
In a historic step toward a healthier, more equitable and affordable
system for financing long-term services and supports, the Leadership
Council of Aging Organizations (LCAO) and the Consortium for Citizens
with Disabilities (CCD) have agreed on a set of joint principles for
reform.

The principles are:

    1. National Problem, National Solution -- Recognize that although states,<br />       communities, families, and individuals have important roles to play,<br />       financing for long-term services and supports is a national problem that<br />       requires a national solution.<br />    2. Universality with Limited Opt-Out -- Create a public program that allows<br />       all people, including individuals with disabilities and those near<br />       retirement, the opportunity to contribute to and prepare for the costs of<br />       long-term services and supports.  Make participation as convenient as<br />       possible but give people the limited choice to opt out.<br />    3. Public/Private Partnership -- Provide a strong foundation of protection<br />       while providing opportunities for personal planning that include a role<br />       for private sector options.<br />    4. Affordability and Risk Pooling -- Provide for broad pooling of risk and<br />       appropriate low-income subsidies to make premiums affordable enough so<br />       that all people, regardless of income and health status, can participate.<br />       Ensure that a new program does not force people to impoverish themselves<br />       to qualify.<br />    5. Fiscal Responsibility -- Provide actuarially sound funding, such as<br />       through voluntary premiums that build reserves over time sufficient to<br />       pay for future needs in a way that is affordable to individuals and to<br />       society as a whole.<br />    6. Relieve Pressure on Medicaid -- Provide additional long-term services and<br />       supports funding mechanisms that will help take the pressure off of<br />       future Medicaid expenditures, while preserving the guaranteed safety net.<br />    7. Consumer Choice and Control -- Promote independence and dignity across<br />       the broad continuum of services and supports by ensuring beneficiaries<br />       the right to control and choose what services they receive, how and where<br />       they are delivered and who provides them.<br />    8. Support Family Caregivers -- Recognize and support the central role<br />       families and other informal caregivers play in planning for and providing<br />       long-term services and supports, including developing strategies to<br />       support working caregivers to maintain their financial security.<br />    9. Invest in Quality Care and Quality of Life -- Target additional funding<br />       to ensure sufficient training and compensation for the workforce and to<br />       strengthen oversight, enforcement, and advocacy programs that improve<br />       quality of life and quality of care in all settings.<br /><br /><br /></pre>
        <div class="p">
            About CCD ( <a class="lk001" target="_blank" href="http://www.c-c-d.org/">http://www.c-c-d.org</a>)

        </div>
    
        <div class="p">
The Consortium for Citizens with Disabilities is a coalition of
approximately 100 national disability organizations working together to
advocate for national public policy that ensures the self
determination, independence, empowerment, integration and inclusion of
children and adults with disabilities in all aspects of society </div>
    
        <div class="p">
            About LCAO ( <a class="lk001" target="_blank" href="http://www.lcao.org/">http://www.lcao.org</a>)

        </div>
    
        <div class="p">
The Leadership Council of Aging Organizations (LCAO) is a coalition of
national nonprofit organizations concerned with the well-being of
America's older population and committed to representing their interest
in the policy-making arena. The 56 members offer expertise and advocacy
on a broad range of issues affecting the elderly and those who care for
them. The coalition focuses on ensuring social justice and fiscal
responsibility for an aging society. </div>
    
        <div class="p">
            SOURCE  Consortium for Citizens with Disabilities

        </div>
    <pre> <a class="lk001" target="_blank" href="http://www.c-c-d.org/">http://www.c-c-d.org</a><br /><br />

Updated Nursing Home Care Resources Released by IQ Nursing Homes

from Transworld News:

IQ Nursing Homes has recently updated its
Nursing Home Resources and is now providing information about nursing
home admission, paying for long term care, and nursing home services.
The IQ Nursing Homes website has been created with the goal of
providing a comprehensive source of nursing home information, and this
recent update marks another step in our progress toward achieving this
goal.

 Visit http://www.iqnursinghomes.com/
to review these new resources. You can also find up-to-date nursing
home news and information about signs of elder abuse and nursing home
neglect on this site.  IQ Nursing Homes offers a free
nursing home abuse claim form, which will be reviewed by a qualified
nursing home attorney within 36 hours. Nursing home employees who have
witnessed neglect can report it anonymously.

John Hancock Announces Results of National Long-Term Care Cost of Care Study

from Virtualization:

BOSTON, Nov. 20 /PRNewswire-FirstCall/ -- John Hancock Life Insurance
Company (John Hancock) today announced the results of an in-depth study of the
2008 costs of long-term care (LTC), which found that LTC costs have been
increasing in line with inflation in recent years.

Including information from more than 11,000 care providers nationwide, the
study of national care costs conducted by CareScout, based in Wellesley, MA,
revealed average costs of care in the U.S. are roughly $75,000 annually for a
private room in a nursing home; $67,000 annually for a semi-private room in a
nursing home; and $35,000 annually for an assisted living facility, while the
average cost of home care was found to be about $19 per hour.

A comparison of the 2008 national averages to those of a similar study
conducted by Harris, Rothenberg International for John Hancock in 2002,
indicates that the increases in costs over the past six years appear to be
tracking inflation, as measured by the Consumer Price Index (CPI) during the
same time period. According to the study, the average annual increase in the
cost of long-term care is trending in line with the 3.3 percent average annual
increase in the CPI during the same time period as noted below.

PHI has supported such alternatives by developing training for staff who were moving from traditional nursing home environments to Green Houses®. THE GREEN HOUSE Project was initially developed by Dr. William Thomas, a professor at the University of Maryland’s Erickson School and leader in the elder culture change movement, who writes a blog called Changing Aging.org. The first Green Houses® opened in Tupelo, Miss., in 2003, to provide seniors of all incomes with more dignity, autonomy, and choice in long-term care. The name stems from the focus on encouraging personal growth among residents. The idea is that Green Houses® cost no more to run than traditional homes because they produce less waste and require less infrastructure.

from Wall Street Journal:

As Budget Shortfalls Force Reductions in Home Care, Low-Income People May Face Nursing Homes, Advocates Say

Faced with widening budget shortfalls, several states are rolling
back support services for the elderly and disabled. The move is making
it tougher for them to continue living on their own, advocates say.

At least 15 states, including Alabama, Virginia and Massachusetts,
are targeting such funding, mostly for programs that allow low-income
shut-ins to receive personal care -- like cooking, cleaning and basic
health services -- in their own homes, according to the Center on
Budget and Policy Priorities, a liberal-leaning Washington, D.C. think
tank that studies state budgets.

The cutbacks are exacerbating the already long waiting lists for
home-care support services in many states. That leaves the low-income
elderly and disabled to dip into their meager incomes to hire their own
help, reach out to family or charity, or seek more restrictive and
expensive care in a nursing home, advocates say.

"We are beginning to see serious cuts and we are expecting those
cuts to get worse," says JoAnn Lamphere, director of state government
relations at AARP, an advocacy group for the elderly.

As the economy falters, declining revenues and tax receipts have led
state agencies to cut spending, with 41 states facing current or
looming deficits, according to the Center on Budget and Policy
Priorities.

A burgeoning market for assisted living and senior living facilities in Mexico is drawing retirement-age baby boomers, according to The Dallas Morning News. Many factors contribute to the appeal of a Mexican retirement, including quality of care, climate and cost, the newspaper reports. A recent MetLife survey places the average cost of assisted care in the U.S. at just over $3,000 per month, while many facilities in Mexico can provide similar care for $1,100 per month, according to the newspaper. Also, many expect that Mexican culture—one that values taking care of the elderly at home—will be suited for the long-term care field. But precisely because of its home-care oriented culture, nursing homes in the country are sparse. The industry is almost entirely deregulated, leading some to question the safety of a Mexican retirement.

from PHI:

Pioneer Network,
a national organization leading the movement for radical change in the
culture of long-term care, is launching the Small House Online
Networking Initiative to bring together key stakeholders to explore the
idea of community-based “small houses” for older adults.

With the support of the Robert Wood Johnson Foundation, the new
initiative aims to enhance communication and shared learning among
those interested in the financing and delivery of person-directed
long-term care through small houses—an alternative to institutional
nursing homes. The virtual meeting place will also provide a forum for
providers who currently run small house initiatives to exchange
information.

PHI has supported such alternatives by
developing training for staff who were moving from traditional nursing
home environments to Green Houses®.

THE GREEN HOUSE Project was initially developed by Dr. William Thomas,
a professor at the University of Maryland’s Erickson School and leader
in the elder culture change movement, who writes a blog called Changing Aging.org.

The first Green Houses® opened in Tupelo, Miss., in 2003, to provide
seniors of all incomes with more dignity, autonomy, and choice in
long-term care. The name stems from the focus on encouraging personal
growth among residents. The idea is that Green Houses® cost no more to
run than traditional homes because they produce less waste and require
less infrastructure.

More U.S. seniors enjoying golden years south of border

from McKnight's:

A burgeoning market for assisted living and senior living facilities in
Mexico is drawing retirement-age baby boomers, according to The Dallas
Morning News.



Many factors contribute to the appeal of a Mexican retirement,
including quality of care, climate and cost, the newspaper reports. A
recent MetLife survey places the average cost of assisted care in the
U.S. at just over $3,000 per month, while many facilities in Mexico can
provide similar care for $1,100 per month, according to the newspaper.
Also, many expect that Mexican culture—one that values taking care of
the elderly at home—will be suited for the long-term care field.



But precisely because of its home-care oriented culture, nursing homes
in the country are sparse. The industry is almost entirely deregulated,
leading some to question the safety of a Mexican retirement.

Elderly People Requires Better Fire Prevention

from Medical news Today:

If you are over seventy years old, your chances of dying in a fire at
home are four times as high as they are for the rest of the population.
It is also a fact that half of all women who die in house fires are 70
or older.

These are among the results of a report from SINTEF
Norwegian Fire Laboratories, which also identifies measures that could
reduce the number of fires, particularly those of electrical origin or
that are due to the inappropriate use of electrical equipment. Taken
together, these are the most frequent causes of fires in Norway.

Elderly Cancer Survivors' Ability To Function Improved By Home-Based Interventions

from Medical News Today:

Climbing stairs, carrying groceries, taking a shower - these are
activities that we take for granted; however, after a cancer diagnosis,
many survivors are unable to function as they used to. Home-based diet
and exercise interventions may improve physical functioning in older,
long-term cancer survivors, according to data presented at the American
Association for Cancer Research's Seventh Annual International
Conference on Frontiers in Cancer Prevention Research.


Wendy Demark-Wahnefried, Ph.D., professor of behavioral
science at the University of Texas M. D. Anderson Cancer Center,
focused this study on survivors older than 65 years old. She said this
age group often suffers long-term side effects of cancer and its
treatment which could threaten the ability to live independently.
"Younger cancer patients are usually able to bounce back, but older
patients may need a structured program to stop functional decline and
retain independence," said Demark-Wahnefried.


Those in the intervention group received tailored mailed print
materials on diet and exercise, a pedometer and exercise bands. For the
first three weeks, participants received weekly phone calls, which
tapered off to every two weeks and then once a month until the end of
the study.


At the end of one year, researchers evaluated physical
function, diet quality and physical activity using standard measures.
Participants in the intervention group demonstrated significant
improvements in their diet and exercise behaviors, and their weight
status. What's more, according to the SF-36 physical function test,
participants in the intervention group had a 2.5 point decline compared
with a 5.3 point decline in the control group. Similar differences were
seen in measures of basic lower extremity and advanced lower extremity
functioning. Overall, the magnitude of effect was similar to preventing
physical function losses comparable to that imposed by ischemic heart
disease.

from Market Watch: LIFE Foundation Reviews Five Facts You May Not Know about Long-Term Care Insurance and Encourages Americans to Assess Their Needs With significant losses to their savings and investments, and economists warning of a prolonged recession, many Americans are feeling uncertain about their retirement security and their ability to pay for long-term care services. According to a new survey by the nonprofit LIFE Foundation, 64 percent of Americans age 45 and older say that the recent economic downturn has had a major negative impact on their ability to pay for long-term care services should they become unable to take care of themselves for an extended period of time. Considering that 70 percent of Americans who reach age 65 will need such care at some point in their lives, according to the U.S. Department of Health and Human Services, these findings show how financially vulnerable many people are without a long-term care plan. Released to coincide with Long-Term Care Awareness Month in November, the LIFE survey found that most adults recognize the reality of needing long-term care services:

from health Care for Health Care Workers:

A testimonial by Cheryl D., a home care consumer in Pennsylvania:

At the age of 14, a cardiac arrest left my son Renzo with a severe
anoxic brain injury. For the last seven years, he has been completely
dependent on the help of direct-care workers. I pay at the higher end
of the wage scale ($10.50 - $15 per hour), but I can’t afford health
benefits for his workers.

Over the years, Renzo has seen more than 40 workers come and go. His
short-term memory is challenged. It’s not until he has had somebody for
two to three months that he can remember their name. And it takes
workers at least a month to understand his patterns of speech.

For every aide that comes in, I am the trainer. I have to teach them
how to help him eat through a straw, how to manage his toileting needs,
and how to help him therapeutically regain limited skills. He has never
really learned to use the augmentative communication device because he
has not had a consistent person to work with him long enough.

Nursing-Home Sex Becoming More Acceptable

from Fox News:

Nursing-home
residents have sexual needs too. And now researchers are finding ways
to educate staff on the taboo topic and provide accommodations for the
elderly to shack up under some privacy.

"Most
staff have the same mindset many of us do, which is 'I don't want to
think about my parents having sex, let alone my grandparents,'" Gayle
Doll, who directs Kansas State University's Center on Aging, told
LiveScience.

The researchers suggest educating staff about sexuality and making sex in nursing homes less hush-hush.

In
the long run, they hope federal guidelines will help all nursing homes
deal with sexuality in a positive way, especially as baby boomers age
and bring their 1950s and 1960s attitudes about sex with them to the
facilities.

Survey Finds Economic Downturn Has Had a Major Negative Impact on Americans' Ability to Pay for Long-Term Care Services

from Market Watch:

LIFE Foundation Reviews Five Facts You May Not Know
about Long-Term Care Insurance and Encourages Americans to Assess Their
Needs

With significant losses
to their savings and investments, and economists warning of a prolonged
recession, many Americans are feeling uncertain about their retirement
security and their ability to pay for long-term care services.
According to a new survey by the nonprofit LIFE Foundation, 64 percent
of Americans age 45 and older say that the recent economic downturn has
had a major negative impact on their ability to pay for long-term care
services should they become unable to take care of themselves for an
extended period of time. Considering that 70 percent of Americans who
reach age 65 will need such care at some point in their lives,
according to the U.S. Department of Health and Human Services, these
findings show how financially vulnerable many people are without a
long-term care plan.

Released to coincide
with Long-Term Care Awareness Month in November, the LIFE survey found
that most adults recognize the reality of needing long-term care
services:

Brainline,org

from Brainline:

This site is supported by the Defense Centers of Excellence.  It is intended to support veterans and other people with brain injuries.  Lots of stuff!

2008 MetLife Assisted Living and Nursing Home Surveys

from Homewatch:

In October 2008, MetLife published their 2008 survey results of Nursing
Home and Assisted Living costs across the US. Nursing Home rates
essentially stayed the same from 2007 to 2008 at at an average of
$212/day for a private room or approx. $80,000/ year. Assisted Living
costs rose by 2% and averaged $3,031 per month or $36,500/year for the
"base rate" which doesn't include some "a la carte" services.
For the full MetLife survey,http://www.metlife.com/FileAssets/MMI/MMIStudies2008NHALCosts.pdf

Integrated Managed Long-Term Care forum

from Patti's Blog:

From the Michigan Department of Community Health:

INVITATION

The Long-Term Care Supports and Services
Advisory Commission
Finance Work Group

is hosting an:

INFORMATIONAL FORUM ON INTEGRATED MANAGED LONG-TERM CARE

December 11, 2008 from 2 to 4 PM
State of Michigan Library Auditorium
Click here for flyer for more info.

CMS issues new guidelines for Medicare Advantage Special Needs Plans

from McKnight's:

The Centers for Medicare & Medicaid Services last Thursday laid out
new guidelines governing Medicare Advantage Special Needs Plans that
serve Medicare beneficiaries with chronic conditions.  



"Based on the panel's recommendations, we are defining the chronic
conditions that certain Medicare special needs plans must use to
identify the beneficiary populations eligible for enrollment," said CMS
Acting Administrator Kerry Weems.



Special needs plans are a type of Medicare Advantage plan that serve
only beneficiaries living in institutions, eligible for both Medicare
and Medicaid, or living with severe or disabling chronic conditions.
The new guidelines, which are based on recommendations from the Special
Needs Plan Chronic Condition Panel, will take effect in 2010. They
identify 15 chronic conditions that will dictate eligibility for a
Chronic Care Medicare Advantage Special Needs Plan. The 15 chronic
conditions include dementia, chronic heart failure, diabetes mellitus,
and stroke.



To view the panel's full report, go to www.cms.hhs.gov/SpecialNeedsPlans.

Another Extendicare Class Action Lawsuit Filed over Nursing Home Neglect in Wisconsin

from Aboutlawsuits.com:

Nursing home operator Extendicare faces a third class action suit,
this time filed on behalf of all residents of their nursing homes in
Wisconsin. Similar Extendicare class action lawsuits
have been filed in Washington and Minnesota, with all of the cases
alleging that the company places profits over patient care by admitting
residents that they are not properly equipped to handle.

The Wisconsin Extendicare lawsuit was filed Friday in the Circuit
Court for Milwaukee County by one resident, but seeks class action
status on behalf of all residents who have been treated at 26 different
nursing homes operated by Extendicare in the state.

Extendicare is one of the largest nursing home operators in the
United States and Canada, with as many as 226 homes in North America
and over 30,000 beds.

The lawsuit alleges that Extendicare fraudulently advertises
services that they are not capable of performing and admits ill
residents without hiring the necessary staff to provide even adequate
care.

New Comprehensive Study of Hispanic Family Caregivers

from Market Watch:

A study released today from UnitedHealth Group's
Evercare(R) organization and the National
Alliance for Caregiving (NAC) finds that more than one third of Hispanic
households (36 percent) have at least one family member caring for an
older loved one --a larger percentage than all
U.S. caregiving households which is 21 percent (one in five), according
to the Evercare Study of Hispanic Caregiving in the U.S. The
study, the largest comprehensive look at Hispanic caregivers, also
revealed that caregiving caused a major change to the working situation
of Hispanics, which could have dramatic personal implications as the
current fiscal crisis continues to unfold in the United States.
Additionally, the emotional and physical tolls of caregiving might also
impact the local and national economies, given that more than eight
million Hispanics provide care to older loved ones nationwide.

Curious Consent Standards in Nursing Home Admissions

from Nursing Home Administrator's Blog:

Nursing home administrators face an unexpected ethical (and legal)
dilemma when admitting new residents to skilled nursing care. The
Nursing Home Care Act undercuts a traditional notion of informed
consent in such a way that many residents may be admitted to a nursing
home without ever consenting to treatment, or having a meaningful
surrogate consent to their treatment. This is clearly an issue of
nursing/medical ethics, as well as a font of potential legal liability
for providing unauthorized care.

American health care law is predicated on the notion of patient
autonomous-direction. Within this notion exist a number of inter-linked
rights: the right to self-determination, the right to give consent
before treatment, the right to information forming the basis of consent
and many others. Curiously, in senior care, as in perhaps no other
major area of American health care law, the status of patient
autonomous direction, especially with respect to consent before
treatment, is less sacrosanct, the exceptions more numerous. This is
especially true in the legal quagmire of involuntarily placing adults
in nursing homes.

I am most familiar with the Illinois Nursing Home Care Act and it
will thus form the background of this discussion, but the Illinois Act
is not dissimilar to Nursing Home Care Acts in many other states, at
least inasmuch as the acts address the issue of involuntary admission.
Clearly involuntary admission of a resident to a nursing home presents
moral and ethical issues most families are not experienced in dealing
with, not to mention attendant feelings of guilt for the family members
and likely betrayal for the patient herself. However, for the health
care provider, the nursing home, the struggle is a balance between
determining the self-interest rights of the resident and the interests
in rendering care.

Better LTC jobs will boost economy, says Kuttner

from PHI:

Economics writer Robert Kuttner has some advice for President-Elect Barack Obama in his new book Obama’s Challenge: America’s Economic Crisis and the Power of a Transformative Presidency.

Kuttner makes a strong case for professionalizing the human services
sector – jobs which are harder to outsource – to boost the U.S. economy.

Last week, he told NPR’s Fresh Air,
“All jobs taking care of America’s children and taking care of
America’s old people and taking care of America’s sick people, by
definition, these are jobs that have to be close to home.”

Scholars Delve Into How Money, Family Structure, and Culture Influence Care of the Elderly

from the Urban Institute:

Who cares for the elderly and at what cost concern policymakers and
laypeople alike, for the Census Bureau predicts that more than 20
percent of the U.S. population will be older than 65 by 2050, compared
to just 12 percent in 2000. Intergenerational Caregiving, a
new book from the Urban Institute Press, reveals how social, cultural,
demographic, and financial circumstances shape care and support
arrangements for Americans as they age, as well as for family members
of all ages facing disability and special needs.

Editors Alan Booth, Ann C. Crouter, Suzanne M. Bianchi, and Judith
A. Seltzer collect the insights of more than a dozen economists and
sociologists, whose detailed essays highlight the issues that
legislators, program managers, and advocates must consider as America
grays. The book cites evidence that the advent of Social Security in
the 20th century improved the financial position of the elderly, whose
higher retirement incomes led to a sharp decline in the proportion of
aged parents living with their adult children. Income and housing
decisions likely would change again if, as one author speculates,
future adjustments to Social Security shrink benefits for retirees or
raise taxes on their adult children.

Class-action suit filed against Extendicare nursing homes

from JSonline:

A Milwaukee attorney filed a class-action lawsuit Friday against
Extendicare Homes that alleges the nursing home chain fraudulently
advertised its services and deliberately admitted more acutely ill
residents without hiring enough staff to properly care for them.

The
lawsuit alleges Extendicare violated the state's Consumer Protection
Act through false advertising that lured residents into believing they
would receive good care at nursing homes that were cited for health
violations by state regulators.

The
complaint also contends the company's "24/7 Extendicare Admission
Policy" was designed to automatically admit patients who have acute
medical conditions such as hepatitis B or who require dialysis or
therapy. Nursing homes are reimbursed at higher rates for more acutely
ill residents.

The
goal of this policy, also known as the "Green Flag" policy, is to admit
the sickest patients regardless of a nursing home's staffing level,
alleged Jay Urban of the Milwaukee law firm Urban & Taylor, who
filed the suit. The Madison law firm Boller & Vaughan are
co-counsel in the lawsuit.

"They
are putting profits ahead of people," Urban said. "You can't take in
higher acuity people unless you provide higher acuity care."

U.S. Residents With Chronic Illnesses More Likely To Experience Medical Errors, Forgo Medical Care Because Of Cost

from medical news Today:

U.S. residents with chronic diseases are more likely to forgo medical
care because of high costs and experience medical errors than residents
of other nations with such conditions, according to a study published
on Thursday in the journal Health Affairs, Reuters/Boston Globe reports. For the study, conducted by the Commonwealth Fund,
researchers surveyed 7,500 adults, each of whom had at least one of
seven chronic diseases -- high blood pressure, heart disease, lung
disease, diabetes, cancer, arthritis and depression. Participants
included residents of Australia, Canada, France, Germany, the
Netherlands, New Zealand, Britain and the U.S.

Okla. To Build Sex Offender Nursing Home

from KOCO.com:

A nonprofit group, A Perfect Cause, said there are currently 30 sex
offenders living in Oklahoma nursing homes. The group hopes that moving
offenders out of those facilities will make them safer for other
residents."The Department of Corrections talked about there
being thousands of people moving from the criminal justice system who
are 65 or older in the coming years," said Wes Bledsoe, of A Perfect
Cause.

Gov. Brad Henry signed a bill into law last July that required the
state to build a separate nursing home for sex offenders. The Oklahoma
Health Department is preparing to seek bids to run the facility, but
also wants to know how those bidders would plan to operate it."The
proposal will include provisions for heightened, 24-hour security to
protect the residents and the public," said Henry Hartsell, of
Protective Health Services.

The Business Innovation Factory’s Nursing Home of the Future: A Place to Design, Test and Learn.

from Nursing Home of the Future:

Overview

The NHoF lab has created a platform to test new ideas in a real world
environment in partnership with designers, clinicians, service
providers, product manufacturers and elder care experts.

Phase I: Understanding the Current Elder Experience

In Phase I, the NHoF team created a detailed description of the
current experience of nursing home and assisted-living residents to
reveal areas most in need of redesign and opportunities ripe for
intervention.

Multimedia

The NHoF team has synthesized phase I work into a series of videos,
vignettes and pictorial displays that make it easier for everyone to
understand the elder care experience see opportunities for improving
it.

After Financial Bailout, a Long Term Care Bailout? No, Industry Expert Says, Pointing to Recent Congressional Action

from MarketWatch:

KIRKLAND, Wash., Nov 12, 2008 /PRNewswire via COMTEX/ --
Will Long Term Care Awareness Week (November 16-22) Help Avert New Economic Tsunami?

Following the $700-billion-plus economic bailout and stimulus program,
"Congress does not relish another big bailout," says Cameron Truesdell,
CEO of LTC Financial Partners LLC (LTCFP), one of the nation's largest
and most experienced long term care insurance agencies. "But they see
another tsunami coming." That's the message Truesdell gets from the
September 25 introduction of House Resolution 431, "Supporting the
goals and ideals of a Long-Term Care Awareness Week."

Consumer Direction in Medicaid and Opportunities for States

from The Heritage Foundation:

The Center for Medicare
and Medicaid Services (CMS) published a final Medicaid rule that
permits Medicaid recipients to self–direct their own health care and
supportive services. The rule, Self–Directed Personal Assistance Services Program State Plan Option (Cash and Counseling),
is a great victory for persons with disabilities. Medicaid recipients
in need of long–term care have been given the freedom to control their
own destiny. If states take advantage of it, this change has the
potential to revolutionize the $100 billion long–term care delivery
system under Medicaid.

Self–direction, with the
benefit of counseling, is a dramatic reversal of the traditional model
of long–term care that is based on dependency. Self–direction puts the
individual back in control. This raises expectations and demands
greater personal responsibility on the part of the Medicaid recipient.
But properly understood, that in itself adds value and quality as well
as expands access to services.

John Kemp, an expert on
disability issues, has explained that "control and choice is not just a
theme; they are a tenet of the disability movement."[2]
Experience shows, moreover, that putting the consumer rather than the
provider in control is also cost effective as well as personally
liberating. Says Kemp: "We have been trying to save our government
money for a long time."[3]

Use of advance directives increases among nursing home residents

from McKnight's:

Advance directive documentation is sharply on the rise in the nation's
nursing homes, according to a recent report from the Institute for the
Future of Aging Services, a research arm of the American Association of
Homes and Services for the Aging.



Nearly 70% of all nursing home residents over the age of 65 have at
least one advance directive document in their records. That is up from
53% in 1996, according to the report.

Crossing The Digital Divide For The Elderly, Chronically Ill And Medically Undeserved

from Medical News Today:

What will motivate the elderly, the chronically ill and the medically underserved to use interactive information technology systems to actively help manage their own health problems? What barriers have prevented people in these groups from using such systems more widely than they have?

The U.S. Agency for Healthcare Research and Quality's (AHRQ) Oregon Evidence-based Practice Center (EPC) at Oregon Health & Science University searched the scientific literature for answers. The EPC's report is the first to identify and catalog the factors that influence the use of home computer-based health IT systems by the most at-risk subgroups of the population and to review the evidence on health outcomes attributable to the use of these technologies. "This report will help us make health information technology more available and accessible to consumers as they use it to become more active in their care," said AHRQ Director Carolyn M. Clancy, M.D. "I hope the report will be useful to clinicians, policymakers, patient advocates and others who are working to integrate health IT solutions that improve the quality and safety of health care for all Americans."

Among the study's findings:

- The most effective systems are those that provide routine and timely tailored clinical feedback and advice. Patients prefer systems that provide them with information that is specifically tailored for them and is not general in nature.

- Patients prefer systems that send them information on devices that fit into their normal daily routine, such as cell phones.

- The lack of a perceived benefit is the primary barrier to wider use by patients of interactive IT technologies. When patients did not perceive a potential health benefit or did not trust the advice they were given they were less likely to use the technology.

- Issues of access, ease of use, and convenience of technology systems were also found to be key barriers to wider use.

- The most frequently used health IT functions are online peer group support bulletin boards and disease self-management tools.

- Patients value the anonymity and nonjudgmental nature of interacting with a computer system, especially those with HIV/AIDS or mental disorders.

Because Of Homecare, Millions Will Share Thanksgiving At Home With Family - November Is National Homecare Month

from Medical news Today:

Thanks to home medical equipment providers, millions of seniors and people with disabilities will share Thanksgiving and other holidays in the comfort of their homes. During November, which is National Homecare Month, the American Association for Homecare celebrates the thousands of dedicated professionals who provide cost-effective and consumer-preferred homecare.

Five Facts about Homecare

1) Among the eight million Americans who depend on homecare for medically required services or equipment are people with chronic obstructive pulmonary disease (COPD), multiple sclerosis, Lou Gehrig's disease, spinal cord injuries, congestive heart failure, diabetes, and other conditions.

2) Virtually every type of healthcare short of surgery can be performed in the home. Today Americans benefit from oxygen therapy, wheelchairs, skilled nursing, sleep therapy, infusion therapy, diabetes supplies, hospice, and other medical services, supplies, and equipment at home.

3) The home is the most cost-effective setting for medical care. Home-based care is a key part of the solution to the severe fiscal challenges facing Medicare and Medicaid and should be an essential part of healthcare reform discussions for federal and state policymakers.

4) Advances in technology for home medical equipment and telemedicine are expanding the clinical effectiveness of homecare.

5) In the event of a pandemic flu, homecare will play a large role in treating the millions of Americans who will require care.

For consumer information and links about homecare, visit www.aahomecare.org/athome.

IU Study Finds 25% Of Family Caregivers Of Alzheimer's Disease Patients Go To ER Or Are Hospitalized

from Medical News Today:

One quarter of all family caregivers of Alzheimer's disease patients succumb to the stress of providing care to a loved one and become hospital patients themselves, according to an Indiana University study published in the November 2008 issue of the Journal of General Internal Medicine.

Researchers from the Indiana University School of Medicine, the Regenstrief Institute and the Indiana University Center for Aging Research report in a new study that a quarter of family caregivers of Alzheimer's dementia patients had at least one emergency room visit or hospitalization every six months.

While it has long been anecdotally recognized that caring for a family member with Alzheimer's disease is stressful, this work is the first to measure just how stressful providing care is and to examine the impact of this stress on both the physical and mental health of the family caregiver.

The study found that the behavior and functioning of the individual with Alzheimer's dementia, rather than cognitive ability, were the major factors determining whether the caregiver went to the emergency room or was hospitalized.

Assistive Technology and Long Term Care

From Michigan's Long Term Care Commission:

The websites for assistive technology are:

View the Video:  "Imagine the Future of Aging" at:
http://www.agingtech.org/index.aspx

The Lifeshirt: http://www.vivometrics.com/research/clinical_trials/about_the_system/what_is_the_lifeShirt_system.php

The Medicine Cabinet of the Future:
http://www.popsci.com/scitech/article/2005-08/inside-medicine-cabinet-future

Accenture's Online Medicine Cabinet:
http://www.accenture.com/Global/Services/Accenture_Technology_Labs/R_and_I/OnlineMedicineCabinet.htm

Nutritional Diet Calculating Scale:
http://www.toplinedigitalscales.com/catalog.php?action=110&cat_id=1

Glad you asked

from McKnight's:

Long a staple for gauging company performance in a service-based
economy, customer satisfaction surveys now are becoming a standard
data-gathering tool in the long-term care industry as well.



Facility operators have only to consider the various factors pushing
the trend to realize the true importance of feedback from those they
serve: Consumer-directed healthcare is gaining traction, the federal
government is unveiling a “Five Star” rating system for nursing homes
in December, the emphasis on pay-for-performance initiatives is
growing, and trade associations are embracing the concept of “culture
change.”



Some see long-term care's mushrooming interest in resident feedback as part of a natural evolution.

“Awareness of customer satisfaction has become pervasive among the
general public,” says Brad Shiverick, chief quality officer for the
Wausau, WI-based healthcare survey firm My InnerView. “For instance,
after a recent trip I got

Elder Care: Elderly Thrive in Denmark

from Spotlight on Elder Abuse: 

WHAT THE DANES REALLY WANT: The Danes do all they can to enable elders to stay in their own homes. And for those who are too frail, the country's nursing homes are small, homey and delightful.

IN TERMS OF services that elderly people actually want, Denmark – and neighbouring Sweden – are the best places in the world to grow old. Both have strong, cradle-to-grave social programs, and compete with each other – and with their Scandinavian cousins Norway and Finland – to give their citizens the best comprehensive elder care.

Danish and Swedish policies are designed to help people stay at home as long as possible through a variety of home-care services and regular house calls by doctors. In Denmark, regular monitoring of an elderly person's needs begin with a visit by a nurse when an individual turns 75. "That visit has a huge impact," MacAdam observes. "It reassures the individual and also educates the individual."

I am struck by the attitude of proud independence I encounter in many of the seniors I meet in the two countries, how they persist in doing the chores they are able to do. The system supports them where needed, but doesn't take over – not even in nursing homes, where they have kitchenettes so they can make their own toast and tea. "The philosophy is that, no matter how frail, you have a right to be in charge of your life," MacAdam says.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

S.3327: Empowered at Home Act of 2008

from OpenCongress:

Empowered at Home Act of 2008 - Amends title XIX (Medicaid) of the Social Security Act (SSA) to revise the income eligibility level for home and community-based (HCBS) services for elderly and disabled individuals. Gives states the option to provide HCBS services under a waiver to eligible individuals whose income does not exceed 300% of the supplemental security income (SSI) benefit rate. Gives states the option to provide HCBS waiver services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care. Directs the Secretary of Health and Human Services to award assistance grants to states electing to provide HCBS waiver services under Medicaid through the state plan amendment option. Reauthorizes Medicaid transformation grants at increased funding and specifies additional permissible uses to facilitate the provision of HCBS and other long-term care (LTC) services. Directs the Secretary to award grants on a competitive basis to eligible states to conduct an evidence- and community-based health promotion program. Amends the Internal Revenue Code to allow: 
(1) a tax deduction for premiums on qualified LTC insurance contracts; and 
(2) a tax credit for certain caregivers taking care of individuals with LTC needs. Revises requirements for the model regulation and model Act concerning LTC insurance consumer protections and the excise tax for failing to meet requirements for such protections. Amends SSA title XIX, with respect to treatment of the income and resources of HCBS waiver services recipients who would otherwise be institutionalized, to repeal the state option, and thus require, application to such individuals of spousal impoverishment protection requirements. Allows states to elect to exclude up to six months of the average cost of nursing facility services from an individual's assets or resources for purposes of eligibility for HCBS waiver services. Directs the Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services, to revise certain data reporting forms and systems to ensure uniform and consistent state reporting under this Act. Directs the Comptroller General to study and report to Congress on: 
(1) the provision of home health services under different state Medicaid plans; and 
(2) the extent to which states offer consumer self-direction of such services, or allow for other consumer-oriented policies with respect to them.

Nursing homes advised to report crimes to law enforcement

from The Norman Transcript: (no relation)

Suspected criminal acts committed against residents of long-term
care facilities are to be reported immediately to law enforcement,
according to an advisory letter sent Oct. 27 from the Oklahoma State
Department of Health to all nursing homes in Oklahoma.

The
letter was sent to all nursing facilities, skilled nursing facilities
and intermediate care facilities for persons with mental retardation.
The letter is in response to appeals by A Perfect Cause and the
overwhelming support for action by long-term care residents' families,
the Attorney General's Office, Oklahoma County District Attorney's
Office, YWCA and Long-Term Care Facilities Advisory Board.

Earlier
this year, Wes Bledsoe, citizens' advocate and founder of A Perfect
Cause, discovered major gaps in Oklahoma statutes concerning the
reporting of criminal acts in long-term care facilities to law
enforcement. He contacted the Oklahoma County District Attorney's
office and Attorney General's Office about his concerns after a
41-year-old nursing home resident was raped and sexually assaulted in
August 2007. Upon further investigation it was determined the rape and
assault were never reported to law enforcement, Bledsoe said.

Nursing homes across the U.S. receive bonuses despite violations

from DesMoinesRegister.com:

Nursing homes throughout the country are eligible for hundreds of
millions of dollars in taxpayer-funded bonuses despite past violations
of basic health-and-safety standards.

A Des Moines Register
review of 81 bonus payment programs in 36 states shows that some homes
are collecting quality-of-care bonuses approved by the same federal
agency that considers them to be below-average caregivers.

In addition, more than 60 bonus programs exist to help nursing homes do
what they are legally required to do, such as pay the minimum wage or
install fire sprinklers for resident safety.

The total cost to
taxpayers is unknown, according to the Centers for Medicare and
Medicaid Services, which approves and helps fund each of the
bonus-payment programs now in effect but does not track any of those
payments.

National Family Caregivers Month

from PHI:

November is National Family Caregivers Month, a nationally recognized time to focus attention on the more than 50 million family caregivers who provide 80% of our nation’s long term care services. It is sponsored by the National Family Caregivers Association.

The theme this year is “Speak Up!” and the NFCA has included resources on their website to help you do this, including the top 10 ways to celebrate and a free teleclass on improving communication.

“Family Caregiver Month is an opportunity to look again at the challenge of how we can better meet society’s need for more quality caregiving, both family and formal, both paid and unpaid,” says PHI Director of Policy Research Dr. Dorie Seavey.

“At a time when the family caregiving ‘system’ is increasingly stressed and the poor quality of direct-care jobs results in high rates of turnover, it no longer makes sense to treat family and formal caregiving as two separate worlds. Our actual practices in providing long-term care have outgrown this construct. That is why PHI is calling for a new policy direction that integrates and supports both family and formal paid care under a common agenda.”

PHI resources on this topic:

• Better Jobs Better Care Issue Brief (pdf)
• National Policy Agenda: Consumer direction and family caregiving (pdf)

Aaron Toleos, Online Communications Director
atoleos@phinational.org

St. Paul Pioneer Press Launches Age Wave, a Long-Term Care Blog

from Changing Aging:

St. Paul Pioneer Press reporter Jeremy Olson has launched a new blog called The Age Wave.  Jeremy has received a fellowship from the Kaiser Family Foundation to look at long-term care today and its future and is writing a series of stories for the newspaper.

In writing the series and the blog Olson says he’s taking his late grandmother’s advice:

“Take care of the corners and the middle always takes care of itself.” Sure, she was talking about spreading frosting, but it applies. By examining individual stories and struggles — by highlighting the hidden corners of long-term care in Minnesota — he intends to identify broader solutions.

Poorhouse to Warehouse: Institutional Long-Term Care in the United States

from Publius:

Nursing homes in the United States are a product of American federalism and reflect the complexities and variabilities of that system. Over time, institutional long-term care for frail elders has shifted from local government funding and administration to state-level oversight and support to a shared federal-state concern. The unsystematic American approach produces haphazard results in terms of quality, equity, and efficiency. The graying of the American population will increase the demand for long-term care, resulting in pressure for a more coherent policy response.

Choice Connections provides consulting on nursing home transition

from BattleCreekEnquirer:

When Tami Roussey gets a call asking for help to find new, safer living
arrangements for an aging loved one, chances are that a sense of
urgency already exists.

Roussey has recently opened an independent placement service to
assist families of seniors who can no longer manage without assistance
in their own homes, called Choice Connections. It is a free, one-stop
service that leads the family and the senior through this emotional and
often confusing time as gently and sensitively as possible.

Each
family is provided guidance and counsel on an individual-needs basis.
When it comes to selecting living accommodations for elderly loved
ones, Choice Connections knows that one size does not fit all. They
will work with the family, identifying specific needs, until choices
are narrowed down to the most appropriate solution for each individual.
They will also schedule tours of different facilities and assist
throughout the transition, until a decision is reached that leaves all
family members with a sense of relief and security that their loved one
will be comfortable and well-cared for in their new living arrangement.
Choice Connections remains in contact to ensure that the senior has
found the perfect place to call home.

Local Expert Shares Three Ways to Save 20-50 Percent On Long-Term Care Insurance

from Bignews.biz:

Irvine, CA--Thanks to increased longevity and advances in health care, Americans are facing a new crisis: a growing need for long-term care. Americans spent over $200 billion on long-term care last year, about a tenth of the nation's health care spending and that number will explode as baby boomers age, explains Jesse Slome, executive director of the American Association for Long-Term Care Insurance.

Most insurers offer preferred health discounts that can reduce the yearly cost by 10 percent. Once you qualify for this discount, you never lose it even if your health changes, explains Petchul.

Adding a deductible to your policy -- something most people have for their car, health and home insurance -- can reduce the cost by roughly 20 percent annually. Over 80 percent of long-term care insurance policies purchased today have a 90-day deductible period, states Petchul. Most people have some savings that will cover the cost during this time period or

Evidence-based research delivers new staff retention tools to nursing homes

from Mcknight"s:

Long-term care providers, who frequently suffer employee turnover rates near 100% annually, have three new resources designed to reduce workforce turnover. The new tools, which were announced Monday by the Better Jobs Better Care Coalition, also can help providers find new employees and create a better work environment for the staff they already have, researchers said. 

The tools are the byproduct of four years of investigation, said the director of BJBC, an initiative managed by the Institute for the Future of Aging Services.

"It's no secret that quality in long-term care cannot be achieved without a quality workforce," says Robyn Stone, Ph.D., executive director of IFAS. "These resources make it easy for providers to take lessons from evidence-based research and use them to transform their organizations."

A catalogue of the group's research shows the benefits of job training programs on staff retention, while a short accompanying video highlights real-world examples of the effectiveness of the programs. A "News You Can Use" fact sheet shows providers where to find new pools of potential employees. More information is available at www.bjbc.org.

Policies for Nursing Home Care Dwindling as Home Care Grows

from market Watch:

Last year not one Unum 
group long term care policy was
purchased for nursing home care only, evidence of a dramatic trend
indicating Americans' desire to "age
in place". In Unum's
third annual Landscape of Long Term Care, the company reports a steady
increase in policies with the home care option.

As the leader in the group long term care market, Unum provides an
annual review of sales and claims trends each fall in recognition of
Long Term Care Awareness Month in November.

"We carefully track these trends so we
understand the needs of our customers," said
John Noble, director of long term care products for Unum. "More
people expect to be able to receive care at home, and making that
possible is an important element of long term care coverage."

Of Unum's inforce policies, 93.4 percent are
purchased to cover some type of home care. And nearly 70 percent of Unum's
group customers use their long term care benefits for care that occurs
in the home.