CareNotes: The Home Care Newsletter Vol 8. Issue 2
Letter From the Editor:
Greetings! We are excited to share the most recent issue of our CareNotes Newsletter in which we discuss the plethora of long-term care options for both moderate and advanced care needs. Adults of every age should plan for, and have a thorough understanding of, long-term care options before you get to the point of needing care. Researching these options can be confusing and overwhelming so we are here to help guide you by educating you on every type of care available. Given our focus on brain health and expertise in dementia care, we also share an article on diabetes and its possible link to Alzheimer’s and dementia. Last, but certainly not least, we would like to acknowledge Lyba Polyakh from Home Care Assistance of Sacramento for being selected as Caregiver of the Month. Thank you, Lyba, for you compassion, dedication and commitment to changing the way the world ages!
Please feel free to contact us if you have any questions or comments related to the articles in our newsletter by replying to this email.
Understanding Long-Term Care Options: Moderate-Level Care
Adults of every age should plan for and have a thorough understanding of long-term care options before you get to the point of needing care. Researching these options can be confusing and overwhelming but educating yourself is essential to planning for your or a loved one’s future care needs. We hope to alleviate some of the stress surrounding long-term care planning with an introductory guide, which will help you make a well-informed decision when it comes to your family’s unique needs and preferences.
In the first of a two-part guide, we feature a variety of long-term care options best suited for individuals that require a moderate level of care but are mostly independent. Read below to learn more about the communities and services to help you age well at home or in a different setting.
Independent Living Facility
This residential living option is appropriate for seniors who are fully or mostly independent and do not require much hands-on care, although they may benefit from other amenities provided. Independent Living Facilities may consist of apartments or complexes restricted by age, which is often 55 years or older, with rent or HOA fees going towards community services such as transportation or communal meals. Alternatively, this retirement community can be made up of homes, duplexes, or condos with an age restriction, and on top of a purchase price for the unit, there may be monthly fees of $1500 to $3500 per month for services. Residents may have to move to another long-term care facility if their health worsens over time as independent living facilities are not equipped to handle individuals with advanced care needs. Many seniors enjoy the community feel of independent living, but most prefer to stay in their own home at this stage.
Assisted Living Facility
For older adults who do not require a high level of care but need assistance to live safely, an assisted living facility can be a good option. These residences are typically made up of individual condominiums within a larger community and provide meals, housekeeping, assistance with daily activities of living, occasional nursing visits and staff available 24/7 for an additional safety precaution. Depending on the facility, seniors are often charged an upfront purchase for their living unit and/or ongoing fees ranging from $2500 to $9000 per month. Even in upscale facilities, staff members are spread across residents, meals are mass prepared at predetermined times and there is limited flexibility or variety in daily routine. At this stage, many choose to continue living in their home with the help of a caregiver, but home care can also support residents of both independent and assisted living for those that want or need extra one-on-one care.
Board and Care Residential Homes
These are private homes that typically serve residents who live together and receive care from live-in caregivers. These care services are appropriate for seniors who require moderate care and who want to be a part of a more private, home-like community. Services often include assistance with daily activities of living like grooming and dressing and amenities vary depending on the cost, which can range anywhere from $1500 to $3000 per month.
Home Health Care
Home health care agencies can provide nursing care and additional services in the comfort of home. This type of care is convenient for individuals recovering from an illness, injury or any hospital stay. Services may include wound care for pressure sores or surgical wounds, intravenous or nutrition therapy, injections, physical therapy, occupational therapy and bathing. This type of medical home care is often used to handle short-term needs such as recovery from a procedure. Doctors may recommend home health care aides and have them coordinate with non-medical caregivers to maintain and update a care plan, check vitals, monitor pain and other medical evaluations or reminders. Costs depend on the type and duration of care required but can range anywhere from $120 to $240 for a single six-hour visit. The Home Care Assistance care team helps coordinate caregivers and home health aides for individuals that choose to stay in their homes but need medical and non-medical support.
Continuing Care Retirement Communities (CCRC)
This living option is optimal for individuals that are healthy and independent now but anticipate greater healthcare needs down the line. These communities offer a spectrum of care ranging from independent living or assisted living to skilled nursing home care all within the same location. The main benefit to this community is that it only requires relocating once to a new environment and can adjust to suit your needs as required. However, this peace of mind comes at a hefty cost, averaging anywhere from $100,000 to $1 million in entrance fees with monthly charges of $3000 to $5000, which may increase as needs change. Similar to independent and assisted living, many residents will hire home care for more personalized help with activities of daily living.
Home care services help individuals who are mostly independent, as well as those with advanced level care needs. Home care is a great option because it allows the individual to maintain or regain their independence while staying in the familiar home environment where they are most comfortable. There are a wide range of home care services, including cooking, light housekeeping, laundry, grocery shopping and errands, transportation, bathing, dressing and grooming assistance, medication reminders, assistance with walking and transferring, companionship and more. Home care agencies can provide hourly or live-in care services and are flexible in adapting to changing needs.
89% of seniors prefer to live in the comfort of home. Moving away to an unfamiliar environment can impact the individual’s emotional wellbeing, which can lead to physical decline, furthering the loss of independence. For seniors that require only a moderate level of care, consider all of the options before making a big move or financial commitment. Stay tuned for the second part of this resource guide on long-term care when we feature options best suited for individuals with advanced care needs.
Understanding Long-Term Care Options: Advanced Care Needs
Long-term care planning can be stressful, which is why we’ve put together a two-part guide on long-term care options that are best suited to you and your loved one’s needs and preferences. In this second installment, we feature long-term care options for individuals that require an advanced level of care. Read below to learn about the main types of services and communities that will help you make a well-informed decision for you or an aging loved one.
Continuing Care Retirement Communities (CCRC)
CCRC’s are suitable for both independent individuals and those with advanced care needs. These communities offer a spectrum of care all within the same setting, including skilled nursing and memory care. However, this peace of mind comes at a hefty cost, averaging anywhere from $100,000 to $1 million to purchase a residence, followed by monthly fees ranging anywhere from $3000 to$5000, which may increase as needs change. Similar to independent and assisted living, residents often will hire supplemental home care for more personalized one-on-one help with activities of daily living.
Memory care, also known as Alzheimer’s or dementia care, is a long-term care option suited for memory-impaired individuals. These living facilities have 24-hour support and structured activities, which are important to ensure safety and quality of life for residents with memory difficulties. This type of care is often provided by skilled or experienced caregivers in an assisted living setting, nursing home or personal care home. Residents live in private or semi-private apartments that have access to outdoor walking paths or gardens within a locked or secured area to ensure residents don’t wander off of the grounds completely. This form of care can cost upwards of $3,000 to $7,000 per month and has the disadvantage of being an unfamiliar living arrangement, which can exacerbate the confusion and agitation an individual with dementia commonly experiences.
Hospice care provides medical services, emotional support and spiritual resources for individuals and their families in the last stages of a serious illness such as cancer. Hospice services aim to improve quality of life and focuses on comfort instead of curative measures. Services are offered in the home or a hospice center and include basic medical care focusing on pain and symptom control, access to a hospice team member 24/7, medical supplies and equipment, support with meal preparation or errands and counseling for the client, as well as their loved ones. Hospice care helps friends and families manage the practical details and emotional hardships of caring for a terminally ill loved one. Medicare, Medicaid and private insurance companies can work with families in need of hospice care services.
Skilled Nursing/Long-Term Care Facility
Nursing homes provide around-the-clock skilled nursing care for individuals who require a high level of medical care. Services vary between facilities but often include monitoring medication, personal care including bathing and grooming, assistance with eating, social and recreational activities and 24-hour emergency care. Skilled care is provided by licensed and registered nurses or specialized professionals trained in physical, occupational or respiratory therapy. This long-term care option is best suited for individuals with complex medical conditions that require routine check-ups and skilled nursing services. Residents in these facilities often share rooms and eat meals in a central dining area, with costs averaging around $4,000 to $8,000 per month.
Home care services can help individuals with advanced care needs and allows the individual to stay in the comfort of home. Services include cooking and meal preparation, light housekeeping, laundry, grocery shopping and errands, transportation, personal care services including bathing, dressing and grooming, medication reminders, assistance with walking and transfers, and companionship, but can also provide a much more customized care plan tailored to the status, conditions, preferences, hobbies and lifestyle of the individual. Most important, older adults can choose the caregiver and level of service they currently need and then adjust their care plan as needs change. A home care provider like Home Care Assistance can provide a much more comprehensive and personalized solution with caregivers that provide one-on-one support. Services are offered on an hourly or 24/7, live-in basis.
9 out of 10 seniors prefer to live in the comfort of home. For seniors that require an advanced level of care, consider all of the options and choose the long-term care that will offer the most security and happiness for your loved one and the greatest peace of mind for your family.
How Diabetes Impacts Brain Health
Worldwide, 387 million people are living with diabetes with numbers expected to increase to 592 million in the next twenty years. If left unmanaged, diabetes can have serious effects on the heart, kidneys, nerves and teeth and puts the individual at an increased risk of stroke and dementia. Now, a new study has found further evidence of diabetes’ impact on brain health by reducing blood flow to the brain and causing cognitive decline in older adults.
Vera Novak, MD, PhD, associate professor of neurology at Harvard Medical School and Beth Israel Deaconess Medical Center, and her colleagues studied sixty-five participants, aged 57-75 years old, for two years – about half of the participants had type 2 diabetes. MRI scans and blood tests monitored inflammation and blood flow in the brain and tests evaluated cognitive functioning of the participants over the two-year span.
The research group found that participants with diabetes had greater declines in gray matter volume and rates of blood flow to the brain. The diabetic group also performed worse than the non-diabetic group on cognitive tests assessing their daily living functions and executive function, or higher-level thinking that includes reasoning, problem solving, judgment and cognitive flexibility.
The observed cognitive decline was caused by changes in the brain. When we use a certain region of the brain, blood vessels provide more oxygen and blood flow to that region by swelling slightly. Diabetes can cause blood vessels in the brain to decrease in flexibility and therefore become less responsive, causing decreased blood flow and symptoms of cognitive decline.
The flexibility of blood vessels was recorded in the study and stayed consistent for participants without diabetes, while declining in those with diabetes. Blood sugar levels that fluctuate in diabetics can damage nerves and cause inflammation, affecting the reactivity of blood vessels. They found that diabetic participants who were on medication and took control of their blood sugars saw the same effect as those who did not, raising concern for the effectiveness for current treatments. Novak and colleagues are now looking into medications that work to improve blood vessel activity in diabetics and prevent future cognitive decline.
If you or a loved one has diabetes, visit your local physician to create a health plan customized to your unique needs. It is important to control blood sugar levels, keep active, eat healthy and keep up with regularly-scheduled appointments to promote your overall health and wellbeing.
Caregiver of the Month Spotlight: Lyba Polyakh
July’s Caregiver of the Month is Lyba Polyakh from Home Care Assistance of Sacramento, California!
Lyba joinen Home Care Assistance nearly two years ago. Ever since her first day on the job, she has been an exemplary employee; not only is she punctual and detailed in her clients’ Care Notes, she also has the best performance record in the entire company. It is this keen awareness and attention to detail that helped Home Care Assistance immediately address a potentially detrimental situation involving embezzlement. Because of Lyba’s detailed notes, Home Care Assistance saved the client over $10,000.
Always going above and beyond to satisfy her clients’ needs, Lyba often stays late to ensure their safety and wellbeing. Her kind, compassionate nature allows her to foster genuine, long-term relationships with the clients she serves, making her a favorite among her clients and their families. After one of her clients lost a beloved pet, Lyba actively looked for and found a new dog for her, illustrating her devotion and commitment to the happiness of her clients.
Lyba’s passion in helping her clients thrive make her a wonderful asset to the Home Care Assistance team. We appreciate her dedication in providing the highest quality care to our clients!