Monday, June 18, 2007

New High Tech elder Care

New high-tech caregiving devices aim to help Canadians care for aging family
Jun. 17, 2007
Provided by: Canadian PressWritten by: NOOR JAVED
TORONTO (CP) - They aren't being regarded as a replacement for human caregivers yet, but researchers hope a number of high-tech devices with the ability to speak, instruct, and even tell a joke will become an invaluable tool in helping Canadian caregivers look after their aging family members.
"There is a real need for technology that can assist in caring for others," said William D'Souza, the Ontario-based creator of Mon Ami, an assisted living device which can operate anything electronic in a home. It can also be programmed to give reminders about medication and appointments, read books and play music.
"We looked everywhere and could find nothing that was comprehensively able to assist people in their day to day tasks, " said D'Souza, who was displaying the multilingual device at a caregiving, disability, aging and technology conference in Toronto.
D'Souza said he came up with the idea for Mon Ami after he was faced with challenges in his own caregiving experience with his elderly father-in-law.
"He wanted to live independently, so we got a housekeeper for him. But even that didn't do, because she would only come in the morning and he was alone for the rest of the day," he said.
Mon Ami, however, allows caregivers to monitor the activities of their loved one remotely - through a log report online or a video camera - and "takes some of the burden or anxiety off of caregivers when they have to be away from their family," D'Souza said.
An estimated three million people in Canada are caregivers and provide care and assistance for friends or family who may be elderly, or face physical, cognitive or mental health conditions, the Canadian Caregivers Coalition says.
But the number of elderly people living independently is expected to increase significantly in the next five years, as the population of baby boomers reaches 65.
"People are living much longer, and are living much longer with greater degrees of disabilities," said the Baroness Pitkeathley, who has been an advocate for caregivers in the U.K for the last 20 years.
"And almost all developed countries are moving towards care at home, rather than care at a residential facility," said Pitkeathley, a keynote speaker at the conference.
She said she believes that while the role of technology is important, it lacks an obvious human element that many elderly people prefer.
"I think clearly there are huge potential for assistance to the caregivers or the cared for person through technology, but I don't think that's ever going to be able to substitute for some of the personal interventions that many people want and need," she said.
Palmier Stevenson-Young, the president of the Canadian Caregivers Coalition, is also skeptical of how effectively the technology will be adopted into caregiving strategies.
"I am sure the technologies are useful to people who know how to use it," she said.
"But there are many people who are being cared for who wouldn't be able to learn new technology."
Another problem, she notes, is that the infrastructure is still not developed enough in many parts of Canada to support such emerging technology.
"Where I live, which is only 41 kilometres north of (Highway 401), near Kingston, we don't have high-speed Internet, and our cellphones don't work," she said. "So I think there are a lot of limits to access to technology."
She says from her experience in working with caregivers, it's the tried and true strategies for taking care of the elderly that seem to work best.
"We need to create caregiving networks, and mobilize volunteers and train them to assist people in their homes, so those people can stay in their homes," said Stevenson-Young.
"If those groups were solid and stable, and had core funding to contin

Sunday, June 10, 2007

The assisted living option

Steps to Finding the Best Assisted-Living Facility by Karen Love

Consumer Consortium on Assisted Living ssisted-living facilities are a bridge between independent home living and residence in a nursing home. Instead of the hospital-like environment of many nursing homes, seniors live in private apartments and share communal dining and recreational facilities. In some cases, it's a bit like living in a hotel, but with the addition of around-the-clock help from staff members. Residents get help, if they need it, with medications, personal care (bathing, eating, dressing, etc.), laundry and other services.

Traps: Assisted-living facilities get varying degrees of oversight from state agencies... the quality of care varies widely... and the fee-for-service plans are often confusing, loaded with fine print and full of hidden costs.

About one million Americans live in assisted-living facilities, a number that's expected to grow as the population ages. Seniors and their families considering an assisted-living facility need to consider such factors as cost, location, services provided, current and future health concerns and the quality of supervision and care. To make the right choice...

List the Main Possibilities
Because seniors who require an assisted-living facility may be physically or cognitively impaired, the decision about which to choose is often made by family members. Start by making a list of facilities that might be appropriate. If you aren't sure where to begin, talk with your doctor or a geriatric care manager. Then visit each of the facilities to see which ones come closest to meeting your (or your loved one's) needs. Looking at many allows you to compare the features of a wide range of facilities. Key factors to consider...

Location. Some people prefer cities, others want a rural environment. Proximity to family members should be a priority.

Range of services. Seniors in reasonably good health might require little more than meals, laundry services, transportation and a range of social activities. Those with serious cognitive or physical impairments might require help with taking medications, bathing, using the toilet, etc. You may have to pay for extra services. Don't get more than you need -- or want to pay for.

Cost. Monthly fees at assisted-living facilities range from about $1,800 to $6,000, with the average charge about $2,500. About 85% of assisted-living residents pay out of pocket. The rest are covered by Medicaid waivers and long-term-care insurance.

Flexibility of care. Consider whether the facility can provide the range of care your loved one might need in the future. Some facilities require residents to move out when health needs change -- for example, if a resident becomes incontinent. Check the contract. This type of contingency should be explained in detail, along with any added costs.

Consult a Care Manager
Experts certified by the National Association of Professional Geriatric Care Managers, Inc. (520-881-8008, www.caremanager.org) can provide information about the facilities you've selected -- and how well they meet personal/medical needs. It's difficult for families to sort through the enormous range of services and prices offered at most facilities. It's also hard for nonmedical professionals to determine what level of care is required. Working with a professional makes it easier.
A care manager can help you decide which facilities provide the best value. He/she can also help you navigate the often-complex contract arrangements.
Example: If a loved one is in good physical health but has been showing signs of dementia, a geriatric care manager will help you choose a facility that provides high-quality dementia support.
Cost: About $300 for an initial consultation, then $100 to $150 per hour for additional visits. One or two hours is usually sufficient.

the Top Picks
Narrow your selection to your top two or three choices. After reviewing brochures and other written materials, visit each facility at least one more time.
Trap: The "chandelier effect." Expensive furnishings and perfectly appointed rooms don't always mean quality care. Residents can be better off in a bare-bones facility with a lively social scene and attentive staff than in a country club-like atmosphere where their needs aren't met. Important...

Visit the facility at a "low-staff" time -- say, between 5:30 pm and 7 pm. Are residents getting attention and help from staff... or do they seem to be on their own?
Does the environment seem chaotic, with phones ringing constantly and staff members running around? This might mean the facility is understaffed.

Get a sense of whether the residents seem relaxed, engaged and happy -- or if they're sitting around with nothing to do. An assisted-living facility doesn't have to be a beehive of activity, but with a few visits, you'll be able to tell whether people seem content or bored.

Arrive unannounced. You can see how the facility normally runs. Talk to residents or visiting family members and get their impressions. You might not be allowed the run of the place if you show up without an appointment, but it's worth trying because you may see what the place is really like.

Check for cleanliness and senior-friendly furnishings -- armchairs that look sturdy, grab rails in bathrooms, no-slip flooring in baths, etc.

Get Staffing Details
Ask the administrator how many staff members are in the building day and night... the level of staff training... and the average length of employment. A revolving door of staff often indicates problems with administration and working conditions.

Try to get a sense of how much time staff members spend with residents. Do they engage the residents... laugh with them... give them personal attention? Or do the interactions seem perfunctory?

Ask About Medications
Errors in medication are among the main causes of poor outcomes at assisted-living facilities. Ask the administrator to explain the medication policy -- who can give medications... what kind of training is required... if a nurse oversees the staff (which my organization recommends).
Ask to see the procedure guide for medication administration. If they won't show it or there isn't such a guide, that's a problem.

Check Complaint History
Every state has a long-term-care ombudsman who tracks complaints and is required to disclose problems with facilities. The Eldercare Locator (800-677-1116, www.eldercare.gov) will direct you to the ombudsman in your area.
Also helpful: Call state licensing agencies for inspection reports, a history of problems, etc. The Web site of my organization, Consumer Consortium on Assisted Living (www.ccal.org), provides contact information for the licensing agencies in each state and helpful consumer resources.

Closely Review the Contract
A 2003 study by the federal Government Accountability Office uncovered frequent incidents of deceptive marketing at assisted-living facilities. Marketing teams often promise more than the facility actually delivers at a certain price.
Example: Families might be told later that a resident's health-care needs are greater than anticipated, requiring extra charges.

A contract should itemize every service (or package of services) and the corresponding fees -- and what conditions (such as changes in health status) could result in higher-than-stated fees. Don't take anything for granted. Some facilities, for example, require residents to use one particular pharmacy -- which might not accept your existing drug insurance. This could add up to hundreds or even thousands of dollars a month.
Important: Ask an elder law attorney to review the contract. It's well worth the cost, generally from $150 to $200. You can find a directory of attorneys at the Web site of the National Academy of Elder Law Attorneys, www.naela.org.

Monday, June 04, 2007

Food safety Margins

What Food 'Sell-By' Dates Really Mean
Suzanne Havala Hobbs, DrPH, RD
University of North Carolina at Chapel Hill any states require food manufacturers to mark perishable foods with a date so that customers can gauge product freshness -- but since there are no federal regulations requiring products to be dated, there isn't a uniform system. Here is a guide to the most common terms and what they really mean...
"Sell-by" dates let stores know how long products can remain on the shelves. They also are used as guides for rotating stock. The sell-by date takes into consideration the length of time a product typically sits on the shelf at home after purchase. Perishable foods remain good for a period of time after the sell-by dates, assuming that they have been stored properly. Use your eyes and nose to judge product freshness. For example, milk, cheese and yogurt that smell sour or have turned color should be thrown out.
General guidelines for shelf life beyond sell-by dates...
Eggs usually are good for three to five weeks past the sell-by date.
Milk typically is good for up to seven days past the sell-by date.
Fresh chicken and turkey should be cooked or frozen within two days after the date.
Fresh beef, pork and lamb should be cooked or frozen within three to five days after the date.
Ground meats should be cooked or frozen within two days of the date.
Unopened processed meats, such as bacon, hot dogs and luncheon meats, should be used within two weeks after the sell-by date.
Unopened canned meats, such as tuna and sardines, will keep for about two years beyond the sell-by date.
"Best if used by" and "use by" dates refer to the point after which peak quality -- flavor or texture -- begins to decline. These are not safety or purchase dates.
Caution: Shelf life depends upon handling and storage conditions. Fresh perishable foods should be kept at 38°F to 40°F for maximum safety and quality.