Legal issues to fight finanial exploitation of the vunerable

Legal Issues in Financial Exploitation
Some but not all abusive actions are defined as crimes. The Criminal Code of Canada describes the different offences that someone can be charged with if they are accused of abusive actions towards older adults. Offences cover physical and sexual abuse, chronic psychological abuse, neglect, loss of rights (under the Canadian Charter of Rights and Freedoms), theft, breach of trust and breach of power of attorney, extortion, false pretenses, fraud and intimidation.

What protection does the law provide?
In addition to the Criminal Code of Canada, there may be provincial statutes that protect you. The courts can impose penalties on people who break the law.
Because not all behaviour considered abusive falls under the Criminal Code, a range of resources and supports are necessary to be able to respond to cases of abuse. And while the definitions presented here are commonly accepted, definitions contained within legislation may vary. This may be important in determining what legal responses are available, and it emphasizes the need for a range of resources and supports.

Suing in Civil Court is also an option in some cases. You can sue the person who has abused you in the civil courts for compensation. If you have had property or money stolen, it might be appropriate to sue the abuser for damages for the amount of the loss or for restitution of the money or property (paying back what they took).
In some cases, mediation between the senior and the offender may be an alternative to a court process. Whether this might be appropriate depends on the circumstances. A lawyer can advise you. It is important to get reliable legal information and advice before starting a legal process. In addition, it is crucial to have efficient legal representation should you decide to follow any of the legal options mentioned above. It is important to consult a lawyer who is experienced in your specific area of concern. There are lawyers who have experience in criminal and civil matters, and some who focus on issues of Elder Law, such as wills, estates and powers of attorney.

What can I do if I am being financially abused?
If you are being financially abused, there are several things you need to know:

• You are not to blame.
• You do not deserve to be abused.
• You have a right to live without fear.
• You have a right to your own money and property.
• You have the right to a safe, healthy relationship and to have your own life.
• You cannot control the abuser's behaviour.
• Abuse often gets worse over time.

If you are not ready, or do not want to do anything right now, that is your choice—it is okay. There are specific actions you can take to stop financial abuse and prevent it from happening again.

You can talk to someone you trust – a friend, relative, clergy or health practitioner, or anyone else you trust. You can also call the police, a senior’s resource centre, crisis line, or legal information agency. Call the Seniors’ Secretariat for information on programs and services in your area.

You can revoke a power of attorney if it is being misused. This is a simple process, requiring a letter drafted by yourself or your lawyer. You will need to send a copy of the letter to your attorney, bank, credit card company and other places where you do business.
You can close any joint bank accounts that you have with the person who is financially abusing you.

You may be able to get a peace bond or restraining order to prevent the abuser from contacting you if you are in fear of the abuser. You have to go to court to get a peace bond.
You can report the abuse to the police, who will investigate to determine if the abuse is a crime, and will make recommendations about how to proceed. You may contact the police about whether the abuse amounts to a criminal offence.

A complete investigation can take considerable time, and there is no guarantee that you will recover any of your lost funds. Nevertheless, it is still important to report economic crime.

What can I do if someone I know is being financially abused?
In all cases of financial abuse, the first consideration should be for the well-being and rights of the senior. If an older person’s safety is in jeopardy, call the police. In other cases, it is important to consider the following:

The older person has the right to self-determination. If they are not ready, or do not want to do anything right now, that is their choice—it is okay. But you can provide information about what they need to know or what they can do if they decide to take action at a later date. Also, by being a good listener and respecting the older person’s wishes, you may ease the concerns of the older person.

In cases where financial abuse occurs at the same time as other forms of abuse and the person is determined to be an “adult in need of protection”, If you have information, whether it is confidential or not, indicating that an adult is in need of protection, you have a duty to report it.

How do I report financial exploitation?
The first step is to call the police. They will carry out an investigation and determine whether the activity is a crime as defined by the Criminal Code of Canada. If it is, the offender can be charged in criminal court and if found guilty of a crime, they will be subject to penalty. Penalties may include a fine, probation, restitution (paying back what they took), a discharge or imprisonment.

If an investigation determines the financial exploitation does not fall under the Criminal Code, you may still be able to sue for damages in civil court. You should consult a lawyer for advice. Not all abuse is a crime. Sometimes, cases can be resolved without going to court. A police investigation can act as a deterrent to the abuser and in some cases may be enough to stop the abusive behaviour. In other cases, a letter from the victim’s lawyer can also act as a deterrent.

Why is it important to get legal advice?
Getting legal advice is a worthwhile investment. Many people are reluctant to contact lawyers for help because they think it will cost too much, or they simply don’t know how to find one. Sound legal advice, particularly from a lawyer who deals with the growing field of Elder Law, can have many benefits. This may include reduced stress, a less complicated and speedier resolution to problems, and having someone who understands and has experience in similar cases. In addition, getting legal advice may help you avoid costly mistakes that can occur when trying to deal with things on your own.

Tips for mind stimulating fun for elders

Tips for Mind-Stimulating Fun
Following, from Home Instead Senior Care, are ways to help engage your senior loved one in mind-stimulating activities:

Video action. Interactive video games have become popular for family members of all ages. Some games, such as Nintendo's Brain Age , and the new Wii home video game system, are particularly good for stimulating seniors minds.

Computer savvy not needed. Even seniors who are intimidated by the computer still can play online and other computer games. Why not try to help them get started playing Solitaire or joining an online bridge game?

Organize game night. Board or card games offer a great avenue for mind stimulation. Why not encourage your senior loved one to get a few friends together to join in the fun?
The magic of music. Many seniors were avid musicians in earlier years and some may still have pianos or instruments in their homes. Ask them to play you a tune or challenge them to learn an instrument.

Tournament fun. Bridge and Scrabble tournaments for seniors are springing up around the country. Check with your local senior center or Home Instead Senior Care office to learn of any activities in your area. Or encourage your older adult to join a local bridge group.

Think big. Crossword, large-piece jigsaw and Sudoku puzzles are great pastimes for seniors who need a mind-stimulating activity when they are alone.

Out and about. Most communities have concerts, lectures and other pursuits that can interest seniors and their families. If your loved one is able to get out, consider those.In the news. Many seniors maintain their interest in politics and current events. For their next birthday, why not renew a subscription to a newspaper or popular news magazine. Or organize a news discussion group.Just the two of you. When it's just you and your senior loved one, remember there are more things you can do than watch television. Hasbro Inc., the largest U.S. game company, has introduced three fast versions of classic board games this year: Monopoly Express, Scrabble Express and Sorry Express. They don't take long to play!

Companionship Counts. Companionship is an important part of stimulating seniors' minds. If your senior has no one to spend time with, consider hiring a companion, such as a Home Instead or BTE CAREGiver.

health care can kill

How Much Is Your Company’s Healthcare Liability?
September 6th, 2007 @ 10:27 am

GM has a total healthcare liability of $64 billion. No wonder the ongoing talks with the UAW are tense and the industry as a whole is struggling to compete (for a fascinating look at how the way America pools risk handicaps auto makers, check out this article by Malcolm Gladwell). But it’s not just the auto industry that’s burdened by the mounting troubles of the American healthcare system. From Michael Moore’s latest film, to the near daily articles about the “obesity epidemic,” to a flood of proposed legislation from Congress, healthcare is on everyone’s mind.
Luckily, many smart people are at work on the issue. This week Forbes.com is pooling their collective wisdom in a feature entitled “Solutions: Healthcare.”
You’ll find AOL founder Steve Case discussing empowering the consumer through his new venture RevolutionHealth.com, and Senator Sheldon Whitehouse’s (D-R.I.) proposal to store every American’s health records centrally and make prescriptions entirely electronic. Michael J. Critelli, executive chairman of Pitney Bowes, urges us to look “at investing in health as we do any other investment, with a payback in terms of not only lower costs for healthcare but reduced absenteeism.” And Princeton Professor Uwe Reinhardt, makes the point that the American healthcare system is no value: we spend twice as much as Canadians per capita. His solution? Invest in “information infrastructure” to get the right information to the right people more efficiently.
Forbes also looks at a topic we recently blogged here on the BNET Intercom: what managers can and should do to improve the health of their teams. Based on your responses, it’s a tricky question that many managers are wrestling with.
These issues, which certainly interest us as citizens, also matter for American business. Problems with healthcare increase the costs of insurance, absenteeism, and reduce productivity due to illness and stress. Forbes is on to something. We need more smart minds thinking about these problems and sharing their insights.

Helpful information on dying with dignity

Planning a Dignified Death for our friend Claire at New Beginnings
Download PDF Version
Transcript
Decision making at the end of life is a critical challenge for the patients, families and physicians involved.1 In the not-too-distant past, families and physicians were often complicit in hiding information from terminally ill patients. Studies show that this practice is much less frequent today. However, physicians in a 2001 study were found to understate the severity of a terminally ill patient's prognosis 63 percent of the time2, and there is general agreement that physicians and health institutions continue to overuse technology and under-use communication when dealing with terminally ill patients. To reinforce this point, an examination of hospital records of 164 patients with significant dementia and terminal metastatic cancer shows that nearly half of the patients received aggressive non-palliative treatments and a quarter received cardiopulmonary resuscitation.3
While it's easy in retrospect to critique such behaviors, the reality is that managing the progression toward death is highly complex. The physician is often asked to bridge the chasm between life-saving and life-enhancing care. Guidance must be highly personalized and must consider prognosis, the risks and benefits of various interventions, the patient's symptom burden, the timeline ahead, the age and stage of life of the patient, and the quality of the patient's support system.

Considering all these, the physician, patient, and family are expected to explore all curative options, provide clear and honest communications, invite family input, provide their best recommendations, and ultimately affirm and support a patient's decision.1
Walking the road of terminal illness carries special burdens for all involved. For the patient and family, shock gives way to a complex analysis that often intersects with guilt, regret and anger. Fear must be managed and channeled, and loss and its implications for family and loved ones cannot be avoided. On top of this, there are multiple complex decisions that must be addressed within specific time constraints.

While all this is extremely difficult for patients and families, it's also demanding of physicians.4,5 The sheer complexity of individualizing and humanizing each passage is complicated by a heavy emotional burden that comes with accepting responsibility for the care of others. Physicians struggle to balance hopefulness with truthfulness. Determining "how much information," "within what space of time," and "with what degree of directness for this particular patient" requires a skillful commitment that matures with age and experience.

Managing both physical and mental health and distinguishing between normal grief and clinical depression add to the challenge.
Finally, incorporating the unique culture and spiritual context that can help define the right course of action for each individual demands a special set of eyes and ears and an ability to reach out and touch.

Studies confirm that 85 percent of terminally ill patients desire as much information as they can get, good or bad. Prognostic information is the most important. Only 7 percent of terminally ill patients seek "good news" exclusively and only 8 percent want no details.4,5
When a diagnosis is first made, everyone's focus is on life preservation. But a sharp decline, results of diagnostic studies, or an internal awareness can signal a transition and lead patients and families to recognize that death is approaching. Once acceptance arrives, end-of-life decision-making naturally follows. Denying that death is approaching only compresses the timeline for these decisions, adds anxiety, and undermines the sense of control over one's own destiny.

With acceptance, the goals become quality of life and comfort. Physicians, hospice, family, and other caregivers can focus on assessing physical symptoms, psychological and spiritual needs, quality of support systems, estimation of prognosis, and defining a patient's end-of-life goals.2 How important might it be for a patient to attend a granddaughter's wedding or see one last Christmas, and are these realistic goals to pursue?
One issue that often gets confused in the process of planning a death with dignity is hope. It is possible to die with hope, with self-control, and with dignity, but it requires some time and planning. Physician participation is critical. End-of-life care expert Dr. David Weissman offers this counsel: "Physicians are often reluctant to provide specific information largely out of fear of destroying hope …. Dying patients can still have hope for system control, of resolving personal relationships, and for a dignified death."1

In order to plan a death with dignity, we need to acknowledge death as a part of life - an experience to be embraced rather than ignored when the time comes. Recognizing when that time has arrived is a critical challenge for each of us.

caregivers use technology

Caregivers use technology to help faraway family
06:52 PM CDT on Sunday, August 19, 2007
By BOB MOOS / The Dallas Morning News bmoos@dallasnews.com
Becky Bashor lives 800 miles away, but she can still look into her mother's eyes every night and tell whether she's had a good day or a bad day.
Ms. Bashor sits down at her computer and signs on to AttentiveCare, an Internet-based service that connects caregivers with their loved ones. She can initiate a videoconference with her mother or just watch unnoticed.
"I can see in an instant how she's feeling," Ms. Bashor said. "One evening, I noticed she was limping around her place, and I asked her why. If I had simply called her, she might not have mentioned she had fallen."
As Americans struggle to look after a growing older population coping with the chronic illnesses and frailties of advanced age, they're turning more to new technology – including Web cameras, pillbox monitors, bathroom sensors and fall detectors – to complement their hands-on care.
Baby boomers' longtime fascination with high-tech gadgets has merged with their elder care responsibilities and created a burgeoning market for such in-home devices and services.
"The technology revolution that's already transformed our lives in many ways, from e-mail to cellphones, is about to transform aging, too," said Majd Alwan, director of the Center for Aging Services Technologies, a national coalition of technology companies, senior care providers and universities.
The technology has moved well beyond "I've fallen and I can't get up" buttons.
Today, sensors can collect information about eating, medication use, sleeping and toilet habits and transmit it to the adult children or professional caregivers via the Web.
Other systems detect nighttime wandering and check blood pressure, body temperature and pulse. Bed sensors can even measure whether someone has gained or lost weight.
The systems raise inevitable questions about privacy, but Ms. Bashor's mother, at least, welcomes the videoconferences with her daughter and doesn't mind the camera in her living room.
"The fact that my family can see me and how I'm doing gives me a sense of security," said Esther Coker, who's 86.
Entrepreneurs in action
Giant companies such as Honeywell International Inc., Intel Corp. and Philips are entering the market, but much of the technology has come from entrepreneurs and start-up companies.
The AttentiveCare system, developed by Caregiver Technologies Inc. of Oklahoma City, provides a virtual window into seniors' homes. It also lets family members post photos of grandchildren and reminders about doctor appointments on the senior's video screen. Caregiver Technologies charges $200 for the setup and $60 a month after that.
Ken Nixon, president of the privately held company, designed the computer software to help with his mother, who was in the early stages of Alzheimer's disease at the time. He has since marketed AttentiveCare over the Internet and by word-of-mouth to about 100 other long-distance caregivers, mostly in the Southwest.
Ms. Bashor's home is in Lawrenceburg, Ind.; her mother lives in Fort Smith, Ark. When Ms. Bashor initiates their videoconferences, a bell rings in her mother's home, and the older woman sits down by the webcam.
"The beauty of this system is that it doesn't require the senior to do anything," Mr. Nixon said. "Most caregivers like to observe unannounced, besides doing videoconferences. You might say they're spying, but they do it out of love."
Another entrepreneur, Vestu Brue of San Antonio, heard friends fret that their aging parents weren't remembering to take their medications. Her answer was a "smart pillbox" called MedSignals that beeps at the appropriate times, dispenses the prescriptions, tracks the use and sends the information to a Web site.
Caregivers then can check whether their loved ones have taken their pills. Clinical trials have found that patients using the device are less likely to miss their medication than those who rely on memory.
Ms. Brue's company, LifeTechniques Inc., will ship the first pillboxes to customers this month. MedSignals sells for $200; caregivers will pay from $3.50 to $15 per month for accessing their seniors' medication use.
Aging in place
Older adults' strong preference to "age in place" is largely propelling the development of the in-home technology, said Richard Lusky, chairman of the applied gerontology department at the University of North Texas.
But the technology benefits family members and professional caregivers as much as it does seniors because it eases the strain of caregiving, he said.
As the 65 and older population doubles over the next 25 years and threatens to overwhelm the nation's long-term care system, the technology may also help delay seniors' nursing home use and hold down costs.
Attracted by the prospect of serving 19 million Americans who care for older adults, Intel has formed a separate research and development unit to create and test an array of home health monitoring products.
"All of our tests have shown that seniors are quite capable of learning and using the technology if they understand the benefits of it," said Eric Dishman, manager of the company's health research and innovation group.
Experts predict the most successful companies in this field will be those that bundle their monitoring and measuring devices into a single package. Right now, Living Independently Group Inc.'s QuietCare may be the most developed system on the market.
With wireless sensors placed throughout the home, QuietCare informs authorized caregivers of any atypical activity that suggests a possible health problem. Frequent bathroom visits might signal trouble, for example.
The private company has sold several thousand systems to individuals and professional caregivers in its 2 ½ years.
QuietCare will soon add a fall detection feature that's triggered when there's an unexplained lack of motion in the older adult's home or room.
"Most existing systems depend on a senior pushing a button for help," said George Boyajian, executive vice president of strategy, research and development for Living Independently. "But in three out of four falls, that doesn't happen."
Austin-based Senior Safe at Home will roll out a system in October that emphasizes both "high tech" and "high touch." The new company will combine home health monitoring equipment with home health care aides.
"The technology is just one component," said interim chief executive Sheri Easton-Garrett. "If someone has a fall, we'll install fall sensors, but we'll also do physical therapy in the home to reduce the risk of another spill."
The business venture grew out of a pilot project by Sears Methodist Retirement System Inc. of Abilene. The pilot found that in-home technology can postpone a senior's need for institutional care by an average of 18 to 24 months.
Ms. Easton-Garrett said the cost of the service will start at $35 to $40 per month, which will provide round-the-clock access to a call center staffed by nurses.
The C.C. Young retirement community in the Lake Highlands neighborhood of Dallas plans to partner with Senior Safe at Home early next year to provide care to older adults who want to remain at home, said Ken Durand, C.C. Young president and chief executive.
Mr. Durand sees senior living communities like his becoming testing grounds for technology that promotes independence. "I've learned that it pays to ride a horse in the direction it wants to go," he said.
Competition at work
A number of senior communities are installing home health monitoring systems because they believe the technology gives them a competitive advantage among prospective residents.
Classic Residence by Hyatt will put sensors in the independent-living residences of its planned 3000 Turtle Creek Boulevard building in Dallas, said Chet Phillips, Hyatt's vice president of information technology.
"Residents appreciate a safety system, as long as it's discreet," he said. "We'll place a single sensor between the bedroom and bath. If there's no motion for 24 hours, it'll alert the concierge, who will send someone to check."
Oatfield Estates retirement community near Portland, Ore., is gaining attention for its extensive use of technology. Although many residents have dementia, the facility doesn't rely on locked doors to prevent wandering.
Instead, residents wear lapel pins that let sensors track their movements throughout the six-acre campus. With a resident's permission, family members can sign in at a secure Web site and follow that person's activities.
"Caregivers love it because they feel involved," said Lydia Lundberg, co-owner of Oatfield Estates. "That's especially important if the senior has Alzheimer's disease and can't tell his family what he's done that day."
Ms. Lundberg and her technology team designed the system's software and have begun to market it to other retirement communities through their new company, Elite Care Technologies.
Don Cline lives just minutes from Oatfield Estates, but he visits its Web site several times each day to see what his mother-in-law, 74-year-old Helen Watkins, is doing and what kind of care she's received from the staff.
"She shows up as an icon on my computer screen at home," said the retired air traffic controller. "I can see where she's at, whom she's having lunch with and how quickly the aides respond when she asks for help."
Though the monitoring is voluntary, most residents choose it because it gives them an added sense of security, Ms. Lundberg said.
Oatfield Estates includes the cost in its monthly service fee, which averages $4,800.
Tricking the system
Mr. Dishman of Intel said seniors generally don't object to the monitoring on privacy grounds because they understand that the technology gives them more independence than they otherwise might have.
"They agree to use it because they prefer to be at home or in their own apartment than in a nursing home, where they'd have no privacy at all," he said.
Still, Sears Methodist chief executive Keith Perry admits that a few seniors sometimes resort to an old-fashioned technique to frustrate the newfangled technology.
"Some of the ladies will occasionally pull out a hanky and throw it over the webcam. I guess there's still a certain level of distrust."

computers make life easy for elders

Computers Make Life Better for the Elderly
"There are three signs of old age," the old joke goes. "First is loss of memory. And I forget the other two." That makes me smile -- but what's underlying this common stereotype about seniors is really not so funny. We all know that age-related mental decline takes simple forgetfulness to far more painful levels.
Computers, of all things, can help -- and not just because they store so much information. It's been demonstrated that brain-teasers and games can help keep mental faculties sharp, and in the past, studies have hinted that computer-based brain games can be especially helpful. (I say "hinted" since many were funded or conducted by software companies with a stake in the outcome.) One I found particularly interesting was recently conducted at the Tel Aviv Sourasky Medical Center of Tel Aviv University in Israel, where a clinical trial compared the cognitive improvements of 121 participants age 50 and older. They were asked to use a sophisticated brain-training program called MindFit or classic computer games (such as Tetris or Labyrinth) 30 minutes a day, three times a week for three months.
PICK A GAME... ANY GAME
Yes, this was one of those studies that received funding by a software company to test their products, so I took their conclusions on that front with a grain of salt. But what grabbed my attention was that in this case, regardless of which computer game or program they used, both study groups experienced improvements in areas such as short-term memory, memory recall and focused attention. The very act of focusing -- attentive participation involving higher order thinking, information integration and judgment -- on mental computer tasks appears to be what helps keep the mind sharp... and that is consistent with past research.
Add to that some of the other ways computers can expand horizons -- including building or maintaining social connections, providing access to information on virtually any topic, and even offering the potential to contribute a valued service to a business or nonprofit -- and it seems an excellent idea to encourage computer use by seniors in your life who aren't already connected.
PROVIDING TECH SUPPORT
A common problem is that computers can be frustratingly difficult for people who lack experience with them. Memory issues, lack of confidence and often sensory problems and decreasing motor skills present obstacles that can seem insurmountable -- but they need not be.
I spoke with Scott Rains, senior advisor to with-tv.com (a television station serving people with disabilities) and former director of programs and services at SeniorNet.org, a nonprofit organization that specializes in computer and Internet education for older adults and seniors. He offered advice on how to help computer-wary seniors get started and/or become more comfortable with the computer...
Focus on their interests. Rains suggests starting with a conversation to assess how a computer can (and actually will) be used, prior to buying equipment and software. For instance, says Rains, grandparents may be interested in staying in touch with family through e-mail or receiving regular digital photo updates, while people who enjoy travel may like the convenience of the many travel resources on the Internet. A benefit for housebound seniors may be that they can let their "fingers do their shopping."
Get the right equipment. Seniors with physical disabilities such as arthritis or poor eyesight, may believe these barriers stand in the way of using a computer. That's not usually the case, as specialized equipment is available to adapt computers for just about any disability or challenge. For example, arthritis sufferers can benefit from large-key keyboards, such as those made by BigKeys Keyboards (http://link.dhn.bottomlinesecrets.com/h/2MWE/HF93/CM/IEIFY) and also specialized "mice" like those from the SmartSolutionPartners (http://link.dhn.bottomlinesecrets.com/h/D9RH/HF93/CM/IEIFY). People with poor vision do better with large-print keyboards, such as those made by ZoomText or screen magnification programs, like BigShot (both at http://link.dhn.bottomlinesecrets.com/h/BES1/HF93/CM/IEIFY).
Take a class. For most inexperienced computer users, success depends on learning how to use the hardware and software. Fortunately there are many resources. "You can find classes at continuing education centers, adult education centers, senior centers, community colleges, libraries and more," says Rains, noting that there are more than 200 SeniorNet Learning Centers across the country, as well. The best senior-oriented computer classes are small, use lots of visual aids, provide a handbook for use at home, work at a pace that allows for plenty of questions and repetition, and are focused on personal enrichment -- not speed, competition or job certification, he says. Ask questions about what classes emphasize before signing up.
Enlist a friendly expert. There are plenty of resources for people who need in-home help setting up computers or solving problems -- including national franchises such as Best Buy, which has partnered with Geek Squad. There is also geeksontime.com. But, says Rains, for computer beginners it can be best to enlist the help of a tech-savvy friend or family member. "You're going to get the best results through an interaction between friends," Rains says. "There's a level of comfort and trust, and a shared culture and language that helps them relate to one another."
Source(s): Scott Rains, senior advisor to with-tv.com and former director of programs and services, SeniorNet.org.

Retirement cost USA

This is a frightening reality of the high cost of aging - this is a universal problem that must be addressed.

Long-Term Care Insurance
Download PDF Version
Thinking about getting older may not be one of your favorite pastimes. But planning for it is essential.

The average cost of one year in a nursing home now exceeds $70,000, but the average net worth of 65 year olds is only $110,000.1,2 This means you could blow through everything you have, including your home, in 18 months or less.

Maybe you’re only in your 40s now and hardly think of your golden years? That’s trouble – the estimated average cost for one year in a nursing home in 2030 is $190,000.3
Now, many of you might be saying to yourselves, “But I don’t want to go to a nursing home” … and you’re not alone there. No one wants to think of themselves as incapable of their own care or consider having someone else run their lives. But the reality is that 60% of current 65 year olds will require some kind of long-term care in their lifetime – either at home, in an assisted living facility, or in a nursing home.4

That’s why so many people are looking with renewed interest at long-term care insurance, a safety-net concept for seniors that has been around for quite some time, but is now suddenly more relevant than ever.

What is long-term care, exactly? It’s different from what most Americans think of as health care, and it usually isn’t covered by health insurance policies, HMO plans or Medicare supplemental policies. Long-term care can range from basic help with tasks around the house to more essential assistance with activities of daily living – like bathing, eating or getting dressed.
Of course, when you’re in your 40s, 50s, or 60s, it’s difficult to predict how much care you’re going to need down the line. But you shouldn’t let that stop you from making financial plans. Currently, only 7% of American seniors have enough saved to cover even one year of nursing home care.2 Thus, 70% of single people and 50% of married couples who require long-term care become destitute.4
You’re not alone, either, if you think you’ll be able to fall back on family members or friends if you get into trouble, and you’ll be able to age in place at home. This might work for some -- if you’re lucky and aren’t disabled or markedly ill, if you don’t have Alzheimer’s or dementia, and if your family is supportive. In fact, nearly 70% of seniors currently receive volunteer care from their family and friends. But looking ahead, this safety net is likely to weaken. With the size of the American family getting smaller, there are fewer adult children to do the caregiving. Also, children live farther away from their parents than they did a generation ago. And lastly, many more women are a part of the workforce now. This changes the future landscape because, out of the current 23 million unpaid caregivers in the U.S., 70% are women. When you consider the unpaid caregivers who provide 40 or more hours of care a week, 80% are women. Given all these factors, it’s obvious that the percentage of seniors who can fully depend on informal caregiving until they die will shrink. 4
In addition to family and friends, Medicaid has traditionally been another fallback for long-term care. Through a variety of legal loop holes, a failing senior or his/her family can “spend down” their assets, basically causing themselves to go broke on paper and then qualify for government payments to a nursing home. But as our society has aged and costs have risen, Medicaid, a partnership between state and federal government, is feeling the strain. Medicaid expenditures now account for about 25% of the average state budget.4 In response, the Deficit Reduction Act of 2005 modified the rules, making it somewhat more difficult, though not impossible, to qualify for Medicaid coverage.5
Are you getting the picture yet? Unless you can afford to pay $70,000 a year now, or an estimated $190,000 per year in 2030, you need to think about long-term care insurance. The policies are increasingly common and flexible, but, of course, they’re not free. It can cost a 55 year old $5,000 per year for a plan that provides $200 per day for a lifetime with an annual 5% inflation adjustment and an initial 60-day waiting period. That probably puts this type of insurance out of reach for a good number of people. But here are a few things you can do to bring down the cost.
Limit the benefit period. Only 8% of seniors require coverage for more than five years. If you go with 5 years of coverage versus lifetime, you’ll save $2,000 per year.3
If you’re married, consider a shared policy. Plans now allow couples to buy two policies almost for the cost of one, and you can share the years. Two six-year policies with a $150 daily benefit can be had for $3,300 a year. So for $1,650 a person, you get 12 years of total coverage that can be split as needed. If a husband requires three years of coverage before passing away, his wife still has nine years of protection in front of her.3
Don’t be penny wise and dollar foolish on key benefits. Since costs can be unexpectedly enormous, be careful with waiting periods. Going from a 90-day to a 180-day waiting period will save you about $200 per year. But if you are unlucky enough to have a debilitating stroke, those first 6 months of uncompensated care in a nursing home will cost you $36,000. Also, be sure to purchase some inflation protection that at least upgrades benefits to match increases in the consumer price index. 3
If you’re in your 50s and healthy, look for an individual policy versus a group policy. Otherwise, you’ll be factoring in the actuarial cost of individuals who are less well than you. And compare prices from a few insurers, including name brands like Genworth Financial, John Hancock, MassMutual, MetLife, New York Life, and Prudential.
The bottom line? You’re not going to be young forever. Set aside some time and money to ensure you’ll have the care you need when the time comes.
For Health Politics, I’m Mike Magee.

Trend:Mexican nursing homes see U.S. influx - FierceHealthcare - Healthcare industry, Healthcare news, Healthcare company, Healthcare trend

Trend:Mexican nursing homes see U.S. influx - FierceHealthcare - Healthcare industry, Healthcare news, Healthcare company, Healthcare trend: "Here's a new example of medical tourism, or at least the export of U.S. medical needs. Increasingly, patients needing nursing care are taking up residence in Mexican nursing homes, particularly patients who live near the border. Not only are Americans coming in and moving straight into nursing homes, the approximately 40,000 to 80,000 American retirees already living in Mexico are trickling into the nursing homes as well. Patients in Mexico typically get dramatically cheaper rates--as little as a quarter of what they pay in the U.S.--along with additional perks like satellite TV, laundry and cleaning service, plus beautiful landscapes and warm weather. They also get access to medical care from the Mexican Social Security Institute, which runs clinics and hospitals across Mexico and allows foreigners to enroll in its program even if they've never worked in the country. Because nursing and assisted-living facilities are a new phenomenon in Mexico, they're not well-regulated as of yet. Smaller facilities run out of homes are a particular risk, according to some critics. However, most facilities seem to be meeting patients' expectations. Look for this to be a huge phenomenon over the next decade, as baby boomers look at local nursing home prices, choke and head for the border."

nursing home trends -usa

Nursing Homes Luring Short-Term Patients
By MARC LEVY, Associated Press Writer
Sunday, March 25, 2007


Back to Health
sfgate_get_fprefs();
(03-25) 16:11 PDT Hatboro, Pa. (AP) --
John Smyth needed more than the big flat-screen TV, towel warmers and homelike furniture offered at the Willow Ridge Center to persuade him to stay in the nursing home's rehab unit following knee-joint replacement.
What sold the 70-year-old retired plumber was the ability to sleep, eat and exercise in space separate from the suburban Philadelphia home's long-term patients — "the really older people," he calls them.
"Both parents died in a nursing home and I guess that sort of put me against it a little bit," said Smyth, a six-inch stripe of metal staples still adorning his garishly swollen right knee.
With billions of dollars at stake, nursing homes across the nation are rushing to reinvent themselves to compete with hospitals and affiliated rehabilitation facilities for short-term, higher-paying patients like Smyth. They are spending hundreds of millions of dollars on renovations and additions and new features like aromatherapy, brightly colored decor, spacious therapy gyms and Internet cafes to try to create a new, warmer, less institutional image.
Most often, they are providing postoperative rehabilitation for knee- and hip-joint patients, but heart attack and stroke victims are also coming in for therapy. Though many are retirees, others are still in the work force and some patients are as young as their 20s.
Offering treatment at lower costs, nursing homes are undeterred by criticism that they do not have the expertise that hospitals do, and that some data show a decline in the quality of their rehab care.
One of the nation's largest nursing-home chains, Toledo, Ohio-based Manor Care Inc., has been among the most aggressive in seeking out short-term patients.
Several Manor Care nursing homes, including one in Boca Raton, Fla., now handle primarily rehab patients and about half of all the patients in the company's 280 nursing homes are now discharged in under a month, said chief operating officer Stephen Guillard.
In its 2005 annual report, Manor Care credited its shifting focus to rehab patients for its revenue growth, which exceeded 6 percent that year.
The prospect of bigger payments has spurred a pace of building unusual for an industry with many properties dating to the 1970s, and which has seen home-based care and assisted-living facilities compete for the older, sicker patients who, while less profitable, have been their core customers for decades.

DependMail: | 07.05.07 | Another hospital to ban pharma freebies

DependMail: 07.05.07 Another hospital to ban pharma freebies: "4. Critics won over by medical tourism options
Comment Forward to a friend
Evidence continues to mount that medical tourism isn't just a novelty, but rather a real and increasingly-popular option for many patients. Currently, 150,000 Americans annually receive treatment in foreign countries, and that number is expanding a remarkable 15 percent to 20 percent per year--boosted by middleman companies like MedRetreat, IndUShealth and Planet Hospital which help patients find the right provider. Critics have argued that despite this growth, medical tourism is still a questionable venture, one that could prove risky and physically taxing.
However, even these critics have begun to admit that leading medical tourism destinations such as India, Thailand, Mexico, Costa Rica, Malaysia and Singapore can offer excellent care, sometimes in comfortable settings that rival U.S. luxury hotels. Then there's the savings, of course, which can be anywhere from 30 percent to 80 percent over U.S. prices. In 10 to 15 years, it will be standard for top foreign hospitals to be included in health insurance networks for Americans, according to Arnold Milstein, chief physician for consulting firm Mercer Health & Benefits"

DependMail: | 07.05.07 | Another hospital to ban pharma freebies

DependMail: 07.05.07 Another hospital to ban pharma freebies: "4. Critics won over by medical tourism options
Comment Forward to a friend
Evidence continues to mount that medical tourism isn't just a novelty, but rather a real and increasingly-popular option for many patients. Currently, 150,000 Americans annually receive treatment in foreign countries, and that number is expanding a remarkable 15 percent to 20 percent per year--boosted by middleman companies like MedRetreat, IndUShealth and Planet Hospital which help patients find the right provider. Critics have argued that despite this growth, medical tourism is still a questionable venture, one that could prove risky and physically taxing.
However, even these critics have begun to admit that leading medical tourism destinations such as India, Thailand, Mexico, Costa Rica, Malaysia and Singapore can offer excellent care, sometimes in comfortable settings that rival U.S. luxury hotels. Then there's the savings, of course, which can be anywhere from 30 percent to 80 percent over U.S. prices. In 10 to 15 years, it will be standard for top foreign hospitals to be included in health insurance networks for Americans, according to Arnold Milstein, chief physician for consulting firm Mercer Health & Benefits"

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

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.

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.

an ounce of prevention

Health care has grown into a colossal tapeworm in the bowels of the Ontario government, devouring cash as quickly as it gets shoveled down the taxman’s maw.

They have thrown significant cash at health care’s many woes. However, the need is for the creation of an integrated health care system where electronic records safeguard against prescription errors, where patients are proactively tested for disease and where doctors and nurses counsel patients throughout their life to guide them to better health. We are nowhere near that and progress to restructure health care to prepare for imminent need has focused on political priorities and acute care needs. One day, and soon, we’ll all pay a price for that. James Wallace is the Queen’s Park bureau chief for Osprey News Network.

Contact the writer at www.ospreymedia.ca.

Tips to Avoid falls for the elders

No More Dangerous Falls

Sometimes a fall is just a minor annoyance, resulting in minor abrasions -- but not always. Falls break bones and tear tendons. Even more worrisome, statistics show that falls are the leading cause of injury-related death among people age 65 and over. This unhappy statistic is partly because older people often have changes in muscle strength, reflexes and coordination. In addition, those with chronic conditions are more susceptible to falling because those conditions may affect balance and certain medications for those conditions can affect balance. But plenty of healthy folks fall as well, including a very good friend of mine who is very active and athletic. If she could fall, anyone can. So, how can you "fall-proof" yourself?

RECENT RESEARCH
In my research, I came across a recent study from the University of Michigan in Ann Arbor about a program called Combined Balance and Step Training (CBST). For this study researchers gathered results from 162 people age 65 and older who were divided into two groups. One group was in a tai chi program, the ancient Chinese mind-body practice... and the other group took CBST. Both groups practiced their particular method three times a week in one-hour sessions over a period of 10 weeks. Interestingly, in spite of tai chi's well established reputation for helping practitioners avoid falls, the CBST group performed slightly better in tests that measured specific abilities that promote fall avoidance. The senior author of the study was Neil B. Alexander, MD, director of the Mobility Research Center at the University of Michigan Geriatrics Center. I called him to find out more about CBST and how it helps people develop fall resistance.

Dr. Alexander first explained that falls generally occur because of a confluence of factors, both internal and external. To explain: You are talking on your cell phone having a heated debate about something and you cross a busy street. You are watching the traffic, but fail to notice the cracked cement on the other side of the street and over you go. A young healthy person might be able to right himself before falling, but that ability decreases with age and not just because of slowed reflexes, says Dr. Alexander. Falling often has to do with not just what you see, but also how you process what you see.

Cognitive decline -- even if mild -- can interfere with visual processing, but so can everyday stress and fatigue whatever your age. The reason: When stressed, your brain may fail to process visual cues, such as something in your peripheral vision that ordinarily you would take note of. Adding to the problem, 9% of people over age 65 have a balance problem that makes them more apt to tip. Dr. Alexander says this is often because of medicine side effects or conditions such as peripheral nerve problems or silent strokes that cause no immediate noticeable symptoms but affect the nervous system over time.

WALK RIGHT
The way people walk -- their gait -- has a great deal to do with how stable they are in motion too. With age, many people start to take shorter and slower steps. (This is also true of people affected by certain disorders such as Parkinson's or osteoarthritis.) But slower steps that are not long enough can make people more vulnerable to falling, says Dr. Alexander. Furthermore, one of the best ways to overcome an imminent fall is to make a rapid step of sufficient length in the direction of the fall, an ability many people lose. Consequently, CBST focuses on teaching participants to take longer steps at a faster speed, exactly the opposite of the shuffle walk associated with some older adults. It's also worth noting that long, fast steps require lifting the feet slightly higher, which provides better toe clearance, which in turn helps prevent a trip over small near-to-the-ground bumps and curbs.

BALANCE RESPONSES
Fall prevention also includes having good balance responses, which means being able to right yourself quickly when you are thrown off balance. To develop these responses, the CBST study group practiced a series of exercises to train them in what Dr. Alexander calls dynamic balance. The following are some examples... a.. Responding to a balance challenge while standing -- for instance, moving the upper body while bouncing and catching a ball. b.. Changing direction while walking, such as walking backward or laterally. c.. Moving from a symmetrical (side by side) to asymmetrical (one foot in front of the other) stance. d.. Maintaining balance while walking on a reduced base of support, such as on a narrowing plank. e.. Braiding/grapevine stepping -- foot in front, foot in back while going sideways. f.. Stepping over small hurdles the height of an average step (about six inches).The group also did modest exercises to increase ankle, knee and hip strength.

PRACTICING AT HOME
Although a CBST program is relatively simple, Dr. Alexander recommends starting such training following a screening by a professional, such as a physical therapist. (These professionals are trained to recognize weak spots and help people achieve their physical goals without causing themselves any injury in the process. He adds that everyone can and should integrate some balance training into an exercise regimen. These need to be more challenging than simply standing on one foot. He advises practicing doing two things at once (catching a ball as you move, for example), walking on something with decreasing support and teaching yourself to take longer, faster steps. Caution: Do not practice any of this without holding on to something stable for support. The idea is learning to prevent falls, not to promote them. Remember, too, that when you are tired, stressed or distracted, your ability to move properly may be hindered -- be especially careful at those times wherever you are. Even better: Be sure you get plenty of rest so your mind and bodily responses are fresh.

THE RIGHT SHOES
One last contributing factor -- what you wear on your feet plays a huge role in whether or not you are vulnerable to falls, says Dr. Alexander. Some soles, such as on sneakers, unfortunately, tend to grip, especially when you change surfaces, say from carpeting to linoleum, or when the surface rises slightly. Wearing sneakers, then, calls for extra awareness. Watch out for the lip (the tip of the shoe where the shoe front meets the sole) of the shoe, and how far it extends in front of your foot. An extended lip easily catches on steps or small hurdles along the way. The worst offenders in the shoe lip problem are sandals and some of the thick-soled shoes that are popular now. As for high heels, well, Dr. Alexander says, one error and you topple. The shoes to look for, then, are those without much lip but with a good fit to provide good support to the foot and ankle (making slippers a no-no). Soles should not be so thick it decreases the sensory input to your foot. If shoes have a slippery sole, scratch them up with a metal brush or the like before you wear them. Shoes without laces (fixation) or slip-ons without a back can also increase risk. Finding the right shoes takes some sleuthing, but fortunately there are many that fit the bill and are even fashionable enough to have you looking good while keeping you safe.

New Horizons for Seniors

Any worthhile seniors or challenge projects out there? qj

New Horizons for Seniors: "New Horizons for Seniors
Call for Applications
New Horizons for Seniors is now accepting applications for funding. View the Call for Applications for your province or territory.

This program provides funding for community-based projects across Canada. Projects encourage seniors to continue to play an important role in their community by:
helping those in need;
providing leadership; and
sharing their knowledge and skills with others.
Calls for Applications are issued once or twice a year. Application deadlines may vary for each province and territory."

Health Telemointoring

Innovations with technology

2. Study: Telemonitoring seems promising

Home-based telemonitoring of patients with chronic diseases has a great deal of potential, according to a new study published this month in a high-profile health IT journal. To conduct the research, which appeared in the Journal of the American Medical Informatics Association, Canadian researchers reviewed more than 65 studies published in the U.S. and Europe. The studies looked at home-based management of chronic pulmonary conditions, cardiac diseases, diabetes and hypertension using remote monitoring technology. While it wasn't clear how large the effect was, home telemonitoring did seem to cut ED visits, hospital admissions and average length of hospital stays, authors said. Telemonitoring seemed to have more impact on pulmonary and cardiac cases than diabetes and hypertension.To get more information on the study:- read this Healthcare IT News articleRelated Articles:USDA offers $128M for rural telemedicine. ReportPartners Healthcare tests remote blood pressure monitoring. ReportFirm offers mobile disease management platform. ReportVendor trials mobile phone-based diabetes monitoring. Report

More help from the the government needed?

Beware the artificial government crisis at hand -QJ

For the past decade, the province has increasingly moved residents out of provincial institutions and into community facilities. Just 500 adult residents remain in three institutions – in Orillia, Smiths Falls and Chatham – and those are being closed by March 2009. More than 40,000 adults with developmental disabilities are now in some form of community care, ranging from help to live on their own or with roommates to group homes and long-term care homes. Approximately 7,000 unionized workers are employed in those community facilities and half, at some 70 locations, are working under contracts that expired March 31.


Labor woes trouble homes for developmentally disabled James Wallace Queens Park - Wednesday, May 09, 2007 By James Wallace Osprey News Network A looming, province-wide labour dispute at agencies that serve developmentally disabled adults could see care jeopardized for thousands of Ontario’s most vulnerable adults, union officials in the sector say. Meanwhile, the $200 million government bailout intended to stave off strikes or lock-outs at group homes, agencies and other community facilities that provide care for adults with developmental disabilities may be fatally flawed, said Sid Ryan, president of CUPE Ontario. Workers in the sector have been frustrated for years over chronically low wages, Ryan said. And despite the recent funding announcement, both CUPE and Ontario Public Service Employees Union locals representing some 3,500 workers report recent strike votes of 95 per cent and higher. “We’re trying to head off labour unrest,” Ryan said. “These are of course, we all know, the most vulnerable of people; people with mental disabilities other disabilities that need a lot of help.” People who work with the developmentally handicapped may typically earn $35,000 or less annually and 25 per cent less than workers doing similar jobs in hospitals, the union maintains. Meanwhile, there is a $10-an-hour gap between the wages for not-for-profit and government staff that do the same work. Ryan said unions and the agencies that provide care urged the government during pre-budget discussions to find the $200 million needed to address wage disparities in the sector.

Photos: Prosthetic arms at play | TechRepublic Photo Gallery

Photos: Prosthetic arms at play | TechRepublic Photo Gallery