Delirium often develops in elderly patients during hospitalization or serious illness, and this acute state of confusion and agitation has long been suspected of having ties to Alzheimer's disease and other dementias.

Now a study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) and Hebrew Senior Life confirms that an episode of delirium rapidly accelerates cognitive decline and memory loss in Alzheimer's patients. The cognitive rate of decline was found to be three times more rapid among those Alzheimer's patients who had had an episode of delirium than among those who did not have such a setback. In other words, the amount of decline you might expect to see in an Alzheimer's patient over the course of 18 months would be accelerated to 12 months following an episode of delirium.

Alzheimer's disease is an irreversible, progress form of dementia that gradually destroys a person's ability to carry out even the simplest of tasks, and affects as many as 4.5 million individuals in the U.S. according to figures from the National Institute on Aging. There is currently no cure for Alzheimer's disease.

Delirium, on the other hand, is a potentially preventable condition, which often develops following a medical disturbance, surgery or infection and is estimated to affect between 14 percent and 56 percent of all hospitalized elderly patients.

In the final analysis was found that, among patients who developed delirium, the average decline on cognitive tests was 2.5 points per year at the beginning of the study; following an episode of delirium, decline nearly doubled to 4.9 points per year.

All elderly patients, but particularly patients who have already been diagnosed with Alzheimer's disease, can benefit from a number of preventive measures if they are hospitalized such as frequent reminder to the patient that he or she is in the hospital(orientation of the patient to his or her surroundings), to allow for as much uninterrupted sleep as possible by not waking patients to take vital signs or do blood draws at night, and to get patients out of bed and walking as soon as their medical condition allows as well as by avoiding to use unnecessary medications( tranquilizers, hypnotics, antipsychotics,etc.).

http://bidmc.harvard.edu

A change in Medicare reimbursement policy could make it more difficult for African Americans with kidney disease to access dialysis services.

Under the new policy, the Centers for Medicare & Medicaid Services (CMS) will make a single payment to dialysis units to cover both dialysis and injectable medications, which were previously reimbursed separately. African American dialysis patients have more problems with anemia (low hemoglobin) than white patients and thus may require more treatment with costly erythropoiesis stimulating agents (ESAs) to raise hemoglobin levels.

Since dialysis centers will no longer be reimbursed for the higher ESA doses, the researchers are concerned that the new policy could create a "financial disincentive" to accept African Americans.

http://www.asn-online.org/

Assisted living facilities could be large( 50 beds or more), medium size( 10-50 beds) and small( 2-10 beds). Each one of them provide senior care and are regulated by the state( in most states) but not all provide the same amount of care. Larger facilities are the ones that can offer the least, and smaller assisted living facilities are the ones that offer the most and have better staffing too.

There are things that most of the assisted living facilities won't tell you:

• They promise more that they can deliver: Many people believe
  that once their loved one is accepted into one of these facilities, he or she will live there for a very long time, perhaps avoiding a nursing home altogether, but only to be faced with the fact that they may need to move their loved one once there is a change in medical condition and more care is needed. You will be asked to move or to provide a private duty aide(which could be costly), and only if your loved one is not bed bounded. Assisted living facilities are not allowed to keep bed bounded patients unless they are under hospice services. The reason that these facilities are doing this is: marketing and the necessity to fill up their beds even if for short time, knowing that this will unconvenience you and your loved one.

 Flying on Air Force One, Obama looked at Pelosi, chuckled and said, "You
know, I could throw a $1,000 bill out of the window right now and make
somebody very happy!"

 Pelosi shrugged her shoulders and replied, "I could throw ten $100 bills
out of the window and make ten people very happy!"

 Michelle added, "That being the case, I could throw one hundred $10
bills out of the window and make a hundred people very happy."

 Hearing their exchange, the pilot rolled his eyes and said to his
co-pilot, "Such big-shots back there. I could throw all of them out of the window
and make 56 million people very happy!"

Many jobs with four year degree will bring you $30/hour or more but here are a few jobs without four years college degree that can bring you the same income:

1. Sales director

Sales directors oversee sales staff to help meet objectives, plan and implement sales programs, and work to maintain budgets, among many other duties. While formal training is not a requirement for this position, sales experience and an outgoing personality are vital.

Salary: $91,900/ $44 per hour

2. Security administrators, computer network

Security administrators work to prevent, troubleshoot, and repair security breaches while educating network users on cyber safety. Certification or relevant experience is essential to entry to this field, especially in absence of a four-year degree.

Salary: $72,000/ $35 per hour

3. Elevator installer/repairer

Elevator assembly, installation and maintenance are the main responsibilities of this position. Participating in an apprenticeship program coupled with paid on-the-job training is the standard, and workers must pass a licensing exam. Union membership is typically required by employers.

Salary: $67,100/ $32 per hour

4. Real estate broker

Usually commission-based, real estate brokers' salaries are sensitive to shifts in the economy. Despite the current real estate market. Brokers are tasked with understanding real estate markets, performing transactions, and advising buyers on their financing options. Additionally, real estate brokers must pass a written exam and maintain a license.

Salary: $65,400/ $31 per hour

5. Nuclear medicine technologist
 

Nuclear medicine technologists administer a type of drug called radiopharmaceuticals to patients and create diagnostic images that ultimately determine the presence of a disease. With an increasingly large middle-aged and elderly population and advances in technology, job growth for nuclear medicine technologists is likely to remain steady. A certificate or an associate's degree is needed, and a license is a requirement for many employers and states.

Salary: $64,100/ $31 per hour

6. Radiation therapist

Administering radiation treatment to cancer patients is the main role of a radiation therapist. There is also room for personal advancement in this field, with opportunities that include teaching and research. Training through an associate's degree or certification program is necessary, and a license is required in many states.

Salary: $63,500 / $31 per hour

7. Construction manager
 

Construction managers oversee the construction of structures, facilities, and systems, and are often on call around the clock. On-the-job construction experience and/or completing a construction management certification program provide entry to this position.

Salary: $63,400/ $30 per hour

8. Air traffic controller

An air traffic controller's job is to keep the skies safe and it is a very demanding and rewarding occupation. Providing an essential role in aviation, air traffic controllers ensure that planes maintain a safe distance between each other and help to coordinate efficient scheduling. With most positions employed by the Federal Aviation Administration (FAA), air traffic controllers must complete a FAA-approved education program and pass a pre-employment test.

Salary: $63,000/ $30 per hour

9. Video game designer

Video game designers create the storyline and structure of a video game and determine the rules of play. They typically need to possess an understanding of software design and computer programming, and a degree or certification from a technical school can provide an advantage. Although currently at a point of high popularity, video games tend to go through phases of increased and decreased popularity.

Salary: $62,300/ $30 per hour

10. MRI technologist

MRI technologists train in programs available through hospitals, colleges and universities to earn a certificate or associate's degree. With more doctors' offices and clinics providing diagnostic services, demand is higher than ever.

Salary: $61,000/ $29 per hour

Assisted living facilities can offer different levels of assistance, from minimal to comprehensive. When choosing an ALF it is important to ask about the level of care the ALF provides, so that you will receive the services you need. Also, the number and types of services can determine the total monthly cost of care. Some ALFs offer specially designed environments for Alzheimer's/Dementia and other memory-impaired patients.

The assisted living facility's staff will manage the resident's care, including ongoing assessments of the resident's needs and health monitoring. ALF staff will coordinate and assist the resident to gain access to needed medical services, as well as mental health, social, educational, and other services. They will also monitor and evaluate the delivery of services. The resident can contract with a third party, like a home health agency or a nurse registry, to provide nursing and other medical services to the resident when needed, as long as the resident's health does not require more care than can be provided in an ALF. The ALF can assist the resident in arranging for such nursing care.

Choosing the right ALF:

• Staffing: How much qualified staff is available each shift to provide personal care, resident supervision and to provide or arrange for scheduled and unscheduled resident services?. What is the ratio of staff to residents?. Assisted living facility's employees are required to have various levels of training depending on their responsibilities. Are the caregivers friendly, respectful and ready to assist you?.
• Financial: Assisted living facilities are, usually, private pay. There are some additional sources that you can use to cover for part or all the assisted living care cost such as veteran benefits, long term care insurances, Medicaid Diversion( if you qualify).
• Cost: Find out price of a private or sharred room. Inquire about additional cost for caring for patients with Dementia/Alzheimer's. How often the monthly rate is increased and by what percentage?. Make sure that everything is mentioned in the contract before you sign it. Any assisted living facility is obligated to give you 30 days notice before any increase in the monthly rate. Is any additional charge for increase in level of care and how much?. What is included in the monthly rent and what services will require additional fees?
• Admission fee and Deposit: Some assisted living facilities may ask for a deposit and admission fees. If these are required, you should ask for the purpose of such fees, whether they are refundable, and, if so, under what circumstances. Most facilities have a policy in place.
• Accommodations: Assisted living facilities offer different type of accommodations based on facility size. Larger ALFs could offer from apartments, to a room with private bathroom and kitchenette, to just a single or sharred room. Residential assisted living facilities( 6 beds or less), most of the time, have only single or sharred rooms with sharred bathrooms. Do the rooms or apartments have telephone access and cable TV and is there an additional charge for the services?. Ask if the rooms/apartments come furnished or unfurnished, if you can bring your own furniture and wall decorations. Is the assisted living facility easy to get around in?. Larger facilities with long hallways and/or multiple levels can be very confusing to patients with dementia and/or Alzheimer's and difficult to access to patients with ambulatory problems. A smaller facility is more suitable for these type of residents. Security and fire safety is very important in assisted living as well. Inquire about smoke detectors, fire sprinkler system and door alarms. Ask about smoking, pet, parking and visiting hours policy.
• Services: Ask about services provided in the facility and which services may require additional cost. There are many other services provided by third party providers such as physicians, pharmacy, laboratory and X-ray, home health services, beautician and barber care. Is the facility going to arrange those services for you?. Some assisted living facilities allow their residents to benefit from hospice services and to "age in place". All assisted living facilities have a bed hold policy for patients that require hospitalization or physical rehabilitation. The patient's family is required to continue paying the assisted living facility to be able to hold the bed. Ask about "bed hold" policy.
• Meals: How many meals and snacks are provided each day?. Ask to see a copy of the menu and see if choices are always available. Most assisted living facilities are offering three meals and snacks per day. It is also important to know if the facility is offering special diets.
• Licensing: Every assisted living facility in Florida is licenced by the state and the license has to be posted in plain view. The "Resident Bill of Rights" must be posted in the ALF in a prominent place along with Long-Term Care Ombudsman poster. You must know where to call in case that you have a complaint.

In the last years residential assisted living facilities have become popular alternatives to nursing homes.

Do you really need a nursing home?. Most of the time no, but people are just not aware of how much care can be provided in a small residential assisted living facility. Those facilities have the highest caregiver to patient ratio giving one-on-one care which no nursing home or larger assisted living facility can provide unless you are paying additionally or by hiring a private duty aide.

Just continue to read about the many services that can be provided to your loved one in a 6-8 bed residential assisted living facility and then decide if you are really in need of nursing home care.

DON'T FORGET!.....Assisted living facilities in Florida do benefit from Medicaid Diversion Program and your relative can have a portion of the assisted living cost covered, usually up to $1100-$1200/month( your relative's monthly income-pension, retirement benefits,etc-plus Medicaid Diversion contribution can not exceed $2400 per month for our facilities with certain programs such American Eldercare, Amerigroup and Citrus). There is a small difference if you are a member of Universal Medicaid Diversion. Their contribution is $1100/month on top of your pension, retirement funds etc. up to $2200/month. So if your pension is $2200/month, the assisted living facility in which you are residing will receive an additional $1100/month coming to a total of $3300/month. In many assisted living facilities( including Phoenix Senior Living), $3300/month will cover private room accommodations.

Mom or dad receives assistance with all activities of daily living, with transfers and ambulation and help with wheechair mobility if they are unable to wheel themselves. Residents with dementia or Alzheimer's will be reminded to eat if needed and food will be cut up for residents with limited manual dexterity.

Many other services are provided as: medication administration( it is centrally locked and controlled by trained personnel), incontinence care and supplies, nutrition is closely monitored( diet provided based on a menu prepared by a registered dietitian), in house visiting physician, optometrist, podiatrist, hairdresser, laboratory and x-ray services.

Medical services are available to residential assisted living facilities and are provided by licensed nurses, physical, occupational and speech therapy through home health services, and the services rendered are covered by the resident's health insurance.

Everybody believed that if mom or dad was a diabetic on insulin, or needed intravenous antibiotics or other injectable medication, they had to go to a nursing home. The concept is wrong because all that can be provided in a assisted living facility under home health services.

Phoenix Senior Living provides all those services and more. Read.....

There are three basic ways to go about hiring a professional caregiver. First, you need to decide whether to hire a private caregiver or go through an agency. While it may be slightly more affordable to find a caregiver on your own, it would be more safe to use an agency. It will be in the best interest of a homecare agency to provide with a competent and experienced caregiver.

There two types of homecare agencies: Full-Service Agencies and Referral Agencies. There is a difference in how they screen their caregivers/home health aids.

Full-Service Agencies: They will provide you with a fully screened caregiver and will continue servicing you thereafter. Some of their services include:

• Prescreening employees for a criminal background
• Checking multiple references
• Maintaining professional liability insurance
• You will be paying the agency for services and the agency will be covering all payroll taxes
• Supplying a caregiver when yours is off or absent
• Replacing a caregiver who isn't a good fit
• Supervising caregivers regularly by sending a registered nurse at intervals

Referral Agencies : Will refer you a caregiver and then your relationship with the agency will end. Referral agencies provide you with a fully screened caregiver but they will not provide any services thereafter. You will be responsible to find a replacement if your caregiver is off or absent, covering any related taxes and you have to supervise the caregiver as well. Some of the services offered by referral agencies include:

• Prescreening employees for a criminal background
• Checking multiple references

Then there is Private-Hire Caregiver when you will find a caregiver on your own( word-of-mouth, recommendations, etc.). This is when you will have to do all the work including criminal background screening.

Everything should be taken in consideration when searching for in home care. The safety and well being of your loved one depends on it.

Passengers on a plane are waiting for the flight to leave. The entrance opens, and two men walk up the aisle, dressed in pilot uniforms. Both are wearing dark glasses. One is using a seeing-eye dog, and the other is tapping his way up the aisle with a cane.

Nervous laughter spreads through the cabin, but the men enter the cockpit, the door closes, and the engines start.  The passengers begin glancing nervously,  searching for some sign that this is just a little practical joke. None is forthcoming.

The plane moves faster and faster down the runway, and people at the windows  realize that they're headed straight for the water at the edge of the airport.

As it begins to look as though the plane will never take off, that it will plow into the water, screams of panic fill the cabin. But at that moment, the plane lifts smoothly into the air.

Up in the cockpit, the co-pilot turns to the pilot and says, "You know, Bob, one of these days, they're going to scream too late, and we're all gonna die."