1. Individuals who need the assistance of another person (caregiver) for eating, bathing, dressing, taking medications, or use of the toilet
OR
2. Individuals who are blind
OR
3. Individuals who live in a nursing home or an assisted living facility.

For veterans who receive home health care services, benefiting from the A&A pension can help offset some of the high long term care costs that senior citizens and their families can face. Since this is a pension benefit, it is not dependent upon military service related injuries or health issues, and can be awarded to surviving spouses of veterans. The funds can be used to pay for assisted living care, care giver services, and nursing home or assisted living costs.

The monthly limits for the A&A pension is $1732 for a veteran, $1113 for a surviving spouse, $2054 for a veteran with a spouse, and $1360 for a veteran with a sick spouse. A unique feature of this benefit is that an independent veteran with a sick spouse can still qualify for the benefit if they can show that the health care costs of the spouse deplete the household’s combined income.

A medical doctor must provide evidence that the individual receiving A&A is unable to function independently. The individual does not necessarily have to meet every requirement outlined in number 1 above. Financially, the individual must claim less than $80,000 in assets, on average, not including homes or vehicles.

The A&A is not intended to be a sole source of income but a supplement for veterans whose elder care is a financial strain. Unlike some types of private and government insurances, A&A is able to pay for in home care providers, which is the preference for many senior citizens with health issues.

1. Independence – senior citizens who continue to live in their homes while using a caregiver experience a sense of independence that may not be possible if they were moved to some type of assisted living residence; by safety proofing their home, activities such as eating, bathing and getting dressed can be accomplished with little supervision by home care aides, which can be instrumental in the sense of well being for the patient
2. Family & Friends – using the services of a home care agency can make it easier for friends and family to visit; the geographical location does not change and there are certain restrictions (such as visiting hours) that do not apply
3. Community – staying connected and engaged in a familiar community can foster a sense of family and security
4. Cognitive Well Being – studies show that people who continue to engage their brains and try to actively learn can help stave off some of the detrimental mental and cognitive effects of aging; private care at home gives senior citizens the freedom to read, work on puzzles or crosswords, participate in intellectual discussions, and pursue hobbies without adhering to the strict schedules of an assisted living facility
5. Exercise – physical activity is crucial to healthy aging; a successful home healthcare nurse is one who can lead her patient in daily activities and exercises appropriate for their particular strength and stamina.

Generally, senior citizens who use homecare services are interested in maintaining their sense of community, independence, and vitality.

Viva Young!

Medicare is a healthcare program that was created in 1965 as a program for senior citizens (over age 65) and disabled people. Medicare is funded by payroll taxes and is NOT based on financial need. Anyone who has somehow paid into the system, with few exceptions, can receive Medicare benefits after they reach the age of 65. To help balance out financial inequality, however, there are certain programs that can help lower income individuals and require wealthier beneficiaries to pay higher premiums. With regards to elder care, Medicare is NOT intended to pay for long term care costs or elder care at home. Most home care givers are relatives, usually adult children, of elderly patients. The cost of long term care can be staggering and many people purchase Long Term Care Insurance while they are young and healthy to help offset the possible future costs.

Medicaid is a federal program that provides medical care to those who meet the low income criteria. Medicaid can help alleviate some senior care costs by providing assistance with long term home care for certain individuals. In the state of Florida for 2013, the applicant’s gross monthly income must not exceed $2130 and they cannot have “countable assets” worth more than $2000. The most common program provided by Medicaid is the nursing home program, which is titled Institutional Care Program in Florida.

There are several different types of home care and it is critical to understand what may or may not be covered under Medicare and Medicaid. Patients seeking information about Florida home care are advised to contact a knowledgeable professional who can provide accurate details about long term care costs.

Where to begin? PREPARE is a website dedicated to guiding individuals through the process of medical decision making. Collaborators to the program are experts in their fields and include health care professionals, professors and information technology specialists.

One of the most unique features of the PREPARE site is the ease of navigation. This user-friendly site implements videos and step-by-step instructions to help even computer novices gather information and develop an action plan for elderly care.

There are several major topics that are addressed on the PREPARE site, including:

1. Choose a medical decision maker, which is the person who can make decisions for you if you are unable or unwilling due to illness or incapacitation
a. It is important to choose this person while you are still of sound mind and body and then legally document your decision
b. Common medical decision makers include a younger relative (such as an adult child) or close friend
c. Items that should be discussed include health care facilities (nursing homes, hospice, hospitals) and medical procedures, especially those that can artificially prolong life

2. Decide what matters most in life; the answers to these questions could help dictate decisions about elderly care
a. Independence versus dependent care
b. Religious beliefs
c. Anything that would cause you to say “Life is Not Worth Living”

3. Document your health care decisions and sharing these choices with family and friends, including those who are NOT your medical decision maker. Discuss options and scenarios with regular doctors and/or specialists and consider creating an Advance Directive with the help of an attorney.

The PREPARE website is an excellent resource for anyone with questions about elderly care.

The Effective Health Care Program (EHC) funds several different networks of researchers, clinical teams and academic organizations throughout North America who then partner with the AHRQ to produce effective and comparative health care research. Specifically, the EHC has three main duties:

1. Review and synthesize published and unpublished scientific evidence as it relates to health care
2. Generate new scientific evidence and analysis through funded research
3. Compile research findings and translate them into useful and readable formats for various audiences, both medical and non-medical.

In addition to the main focus of the EHC, the program also produces three different types of products:

1. Research reviews – these reports take completed scientific studies and then compare them to different health care interventions; research reviews can either be technical briefs (explaining what is known about new treatments) or effectiveness reviews
2. Original research reports – these reports take clinical research and then raise questions about the benefits or harm of the data
3. Summary guides – these are plain language guides that are tailored to clinicians, consumers or policymakers that summarize research findings.

Consumers can take part in the EHC by suggesting research topics, commenting on key issues, and make direct requests to researchers. For more information, visit http://www.effectivehealthcare.ahrq.gov/

Clinical trials usually begin in a laboratory. Researchers conduct a variety of tests and figure out which methods are unusable and which need to be tested further. In some cases, people volunteer to participate in carefully regulated investigations to test new medications, therapies, or treatments. These experiments follow strict protocols, which are monitored by the Institutional Review Board (IRB) of the United States. The IRB is an independent committee that is comprised of physicians, statisticians and community members whose goal is to ensure the safety of clinical trial participants. They also make sure that the protocol is legal and ethical. Within the protocol is a thorough, step by step description of the clinical trial including: who is eligible to participate and why; details about the tests, procedures, medications and dosages; a statement about the goals of the trial and what information will be gathered. The leader of the protocol is called the principal investigator (PI), who is usually a highly credentialed medical doctor or scientist. Their research team carefully monitors the health and safety of the participants.

Types of clinical trials include:

1. Natural history studies – investigates how a disease progresses
2. Prevention trial – looks for ways to prevent a disease in those who have never had it by using medications, vaccines, or lifestyle changes
3. Screening trial – detects certain conditions or diseases
4. Diagnostic trial – determines better tests or procedures for diagnosing a disease
5. Treatment trial – tests new drugs or approaches to therapy or surgery
6. Quality of life trial – explores ways to improve the quality of life for people with a chronic condition.

People volunteer for clinical trials for several reasons. Healthy people volunteer to help others and because of a desire to contribute to science. Those with illnesses or diseases may be hoping to find new treatments that will not only be beneficial to them but others who suffer from their condition. Clinical trials are an integral part in having a new drug approved by the FDA, which is one of the ultimate goals of researchers.

Occupational therapists help their patients improve the way they handle daily tasks, such as dressing independently, performing hygiene tasks, or using a computer. Often the patients of occupational therapists have suffered some sort of physical or mental setback (such as an illness, accident or stroke) that has diminished their ability to perform tasks that were formerly easy. Occupational therapy can increase a patient’s basic motor functioning skills and their strength and dexterity.

Physical therapy helps patients that have limited physical mobility. One aspect of physical therapy is developing individualized fitness and treatment plans based upon the particular limitations and goals of the patient. Examples of conditions that would require physical therapy include hip replacement surgery, back and neck injuries, arthritis, bone fractures, and strokes. Physical therapies may include therapeutic exercise, manual therapy techniques, employment of adaptive devices, and functional training.

Speech therapists will assess, diagnose and treat disorders that are related to speech, language, voice, swallowing, and cognitive communication. Speech therapy is often prescribed for stroke victims who have lost some or all of their ability to talk. It can also be useful for dementia patients or others who have lost any of their cognitive memory skills.

Therapy can be highly beneficial to patients who are willing to put in the time and effort to see improvements, and have caregivers who are supportive of the process.

1. Is the agency licensed at both the state and federal level?
2. Does the agency accept Medicare? What are the financial costs and payment methods of their particular home health care offerings? How are the services billed and how is insurance involved?
3. Is the agency accredited by independent resources? Can they share any recent reports, including complaints leveled against the agency?
4. Can the agency provide references (clients, doctors, or hospitals who have worked with the agency)?

In addition to analyzing the business processes of a home health care agency, families must consider the actual employees who will become the caregivers. Ask about the agency’s screening process, the level of certifications and credentials of the employees, and their initial and ongoing training programs.

It is equally important for the patient to feel comfortable with their particular caregiver. Some qualified caregivers may be very good at their job but do not “click” with their patient, whether because of a personality clash or any other reason. Families have every right to remedy this situation, usually with a new caregiver. Families should also ask for a list of specific responsibilities of the caregiver, including what will happen if the caregiver is sick or on vacation.

Finally, families should ask how conflicts are resolved and what is the procedure for addressing any complaints or issues the patient may have. The goal of successful home health care agencies is to foster a healthy, happy relationship among caregivers, patients and families.

Unfortunately, there is no guaranteed way to prevent cancer from occurring, but there are steps that people can take to help prevent it from forming, including:

1. Maintaining a healthy body weight
2. Participating in physical exercise
3. Eating a nutritious diet that is high in vegetables, fiber, fruit and whole grains
4. Avoiding smoking or excessive alcohol use
5. Avoiding overexposure to the sun and always using sunscreen.

After a cancer diagnosis, patients and their caregivers are usually eager to hear what types of treatments are available. This depends upon the type of cancer, what stage it has progressed into, and the level of aggressiveness of the cancer. Other factors to consider include the location and size of the cancer in the body and the general health and medical history of the patient. Three of the most well known types of treatment include:

1. Chemotherapy – uses drugs to destroy cancer cells and stop them from spreading; side effects can be brutal and include nausea, hair loss, extreme fatigue, and pain
2. Radiation – uses high energy radiation to kill cancer cells by damaging the cell’s DNA; side effects can include damage to nerve cells
3. Surgery – surgical removal of cancerous tumors; sides effects can be a failure to remove every cancer cell in the body, causing a reoccurrence of the disease.

Obviously patients and their caregivers must work carefully with their physicians to determine the best type of treatment for cancer.

When using a wood burning stove, there should be a glass front or large screen that catches any falling embers or logs; the chimney flue should be inspected by a professional to make sure it works properly. In case of a power outage, the house should be stocked with candles, flashlights, water, food, and plenty of blankets and other ways to stay warm.

Auto safety in winter is very important. If the senior citizen is still driving, it should only be in optimum driving conditions. The tire pressure should be checked and the car equipped with the proper traction tires, if necessary. The car should have full levels of anti-freeze, the belts should be free of cracks, and the battery should be fully charged and operational. Running out of gas is always inconvenient, but it can be especially dangerous in cold weather to get stranded.

When going outside for any reason, even if it is just walking to the car, caregivers should take great care to keep their patients off of icy stairs and sidewalks to avoid falls and broken bones.