Most People Can Donate Organs and/or Tissue

All people of all ages should consider themselves potential organ and tissue donors. There are few absolute exclusions (HIV positive, active cancer, systemic infection) and no strict upper or lower age limits. Potential donors will be evaluated for suitability when the occasion arises.

You Are Never Too Old

No one is too old or too young. Both newborns and senior citizens have been organ donors. The condition of your organs is more important than age. Someone 35 years old with a history of alcohol abuse may have a liver that is in worse condition than someone 60 years old who has never consumed alcohol. In addition, people on the waiting list might need to be transplanted with an organ that is less than ideal if there is no other suitable organ available in time to save their lives. Doctors will examine your organs and determine whether they are suitable for donation if the situation arises. If you are under 18, you will need the permission of a parent or guardian to donate.

Medical Condition? Don’t Rule Yourself Out

You may still be able to donate your organs. Doctors will evaluate the condition of your organs when the time arises. The transplant team’s decision will be based on a combination of factors, such as the type of illness you have had, your physical condition at the time of your death, and the types of organs and tissues that would be donated.

What can be Donated? – Organs, Tissue, Stem Cells, Blood and Platelets

Organs

The organs of the body that can be transplanted at the current time are kidneys, heart, lungs, liver, pancreas, and the intestines. Kidney/pancreas transplants, heart/lung transplants, and other combined organ transplants also are performed. Organs cannot be stored and must be used within hours of removing them from the donor’s body. Most donated organs are from people who have died, but a living individual can donate a kidney, part of the pancreas, part of a lung, part of the liver, or part of the intestine.

Local organ procurement organizations (OPOs) around the country coordinate organ donation. OPOs evaluate potential donors, discuss donation with surviving family members, and arrange for the surgical removal and transport of donated organs. A national computer network, the OPTN (Organ Procurement and Transplantation Network) matches donated organs with recipients throughout the country.

Tissue

Corneas, the middle ear, skin, heart valves, bone, veins, cartilage, tendons, and ligaments can be stored in tissue banks and used to restore sight, cover burns, repair hearts, replace veins, and mend damaged connective tissue and cartilage in recipients.

Stem Cells

Healthy adults between the ages of 18-60 can donate blood stem cells. In order for a blood stem cell transplant to be successful, the patient and the blood stem cell donor must have a closely matched tissue type or human leukocyte antigen (HLA). Since tissue types are inherited, patients are more likely to find a matched donor within their own racial and ethnic group. There are three sources of blood stem cells that healthy volunteers can donate:

Marrow-This soft tissue is found in the interior cavities of bones and is a major site of blood cell production and is removed to obtain stem cells

Peripheral blood stem cells-The same types of stem cells found in marrow can be pushed out into a donor’s bloodstream after the donor receives daily injections of a medication called filgrastim. This medication increases the number of stem cells circulating in the blood and provides a source of donor stem cells that can be collected in a way that is similar to blood donation.

Cord blood stem cells-The umbilical cord that connects a newborn to the mother during pregnancy contains blood and this blood has been shown to contain high levels of blood stem cells. Cord blood can be collected and stored in large freezers for a long period of time and therefore, offers another source of stem cells available for transplanting into patients.

Blood and Platelets

Blood and platelets are formed by the body, go through a life cycle, and are continuously replaced throughout life. This means that you can donate blood and platelets more than once. It is safe to donate blood every 56 days and platelets twice in one week up to 24 times a year.

Blood is stored in a blood bank according to type (A, B, AB, or O) and Rh factor (positive or negative). Blood can be used whole, or separated into packed red cells, plasma, and platelets, all of which have different lifesaving uses. It takes only about 10 minutes to collect a unit (one pint) of blood, although the testing and screening process means that you will be at the donation center close to an hour.

Platelets are tiny cell fragments that circulate throughout the blood and aid in blood clotting. Platelets can be donated without donating blood. When a specific patient needs platelets, but does not need blood, a matching donor is found and platelets are separated from the rest of the blood which is returned to the donor. The donor’s body will replace the missing platelets within a few hours.

Types of Donation

Organ and Tissue Donation from Living Donors

While most solid organ and tissue donations occur after the donor has died, some organs and tissues can be donated while the donor is alive. The first successful transplant in the U.S. was made possible by a living donor and took place in 1954. One twin donated a kidney to his identical twin brother. As a result of the growing need for organs for transplantation, living donation has increased as an alternative to deceased donation, and about 6,000 living donations take place each year. Most living donations happen among family members or between close friends. Some living donations take place between people unknown to each other.

Solid Organ Donation

Living individuals can donate one of their two kidneys and the remaining kidney provides the necessary function needed to remove waste from the body. Single kidney donation is the most frequent living donor procedure.

A living donor can donate one of two lobes of their liver. This is possible because, just as skin cells grow new skin, liver cells in the remaining lobe of the liver grow or regenerate until the liver is almost its original size. This re-growth of the liver to near its original size occurs in a short period of time in both the liver donor and liver recipient.

It is also possible for living donors to donate a lung or part of a lung, part of the pancreas, or part of the intestines. Although these organs do not regenerate, both the donated portion of the organ and the portion remaining with the donor are fully functioning.

Surprisingly, it is also possible for a living person to donate a heart, but only if he or she is receiving a replacement heart. This occurs only when it is determined that someone with severe lung disease and a normally functioning heart would have a greater chance of survival if he or she received a combined heart and lung transplant. As a result, the heart-lung recipient’s own heart, if it’s in good condition, is then donated to an individual who needs only a heart transplant.

Tissue Donation

Tissues donated by living donors are blood, marrow, blood stem cells, and umbilical cord blood. A healthy body can easily replace some tissues such as blood or bone marrow. Blood is made up of white and red blood cells, platelets, and the serum that carries blood cells throughout the circulatory system. Bone marrow contains stem cells. In addition, stem cells found in circulating blood in adults and from the umbilical cord of a newborn also can be donated. Both blood and bone marrow can even be donated more than once since they are regenerated and replaced by the body after donation.

Suitability to Donate

Each potential living donor is evaluated to determine his or her suitability to donate. The evaluation includes both the possible psychological response and physical response to the donation process. This is done to ensure that no adverse outcome, either physically, psychologically, or emotionally, will occur before, during, or following the donation. Generally, living donors should be physically fit, in good health, between the ages of 18 and 60, and not currently have or have had diabetes, cancer, high blood pressure, kidney disease, or heart disease.

The decision to be a living donor must be weighed carefully as to the benefits versus the risks for both the donor and the recipient. Often, the recipient has very little risk because the transplant will be life saving. However, the healthy donor, does face the risk of an unnecessary major surgical procedure and recovery. Living donors may also face other risks. For example, a small percentage of patients have had problems with maintaining life, disability, or medical insurance coverage at the same level and rate. And, there can be financial concerns due to possible delays in returning to work because of unforeseen medical problems.

Follow-up for Living Donors

The National Institutes of Health is in the process of conducting a study to collect information on the outcomes of living donors over time. At present, follow-up reviews of living donors by some transplant centers show that living donors, on average, have done very well over the long term. However, there are some scientific questions regarding the effects of stress on the remaining organ. There could be subtle medical problems that do not develop until decades after the living donation that are not known at this time because living donation is a relatively new medical procedure. To ensure the safety of all living donors, it is critical that the long term results of the effects of living donation are studied further.

The Decision to Donate

The decision to be a living donor is a very personal one and the potential donor must consider the possibility of health effects that could continue following donation. In most cases, that decision must also take into consideration the life-saving potential for a loved one-the transplant recipient.

Because all of the effects, especially the long term effects, to the donor are not known at this time, the Federal government does not actively encourage anyone to be a living donor. The Federal government does recognize the wonderful benefit that this gift of life provides to the patient awaiting a transplant and has several ongoing programs to study, support, and protect the living donors who do choose to provide this gift.

The decision to say yes to both organ donation after death and/or as a living donor is the focus of many very active and successful research projects that are being conducted across the nation, and these efforts are supported by the Division of Transplantation, Health Resources Services Administration, U.S. Department of Health and Human Services.

Federal Assistance for Living Organ Donors

In September 2006, HRSA awarded a cooperative agreement to the University of Michigan to establish a national program to provide reimbursement of travel and subsistence expenses to living organ donors who cannot afford these expenses. In October 2007, the University of Michigan in partnership with the American Society of Transplant Surgeons launched the National Living Donor Assistance Center to help donors with travel, lodging, and meal expenses associated with the organ donation process. For more information visit the National Living Donor Assistance Center Web site (not a U.S. Government Web site)

Donation after brain death

Most of the organs used in transplants come from people who have suffered brain death as the result of an accident, heart attack, or stroke. Brain death is total cessation of brain function, including brain stem function. There is no oxygen or blood flow to the brain; the brain no longer functions in any manner and will never function again.

The organs and tissues that are in good condition are removed in a surgical procedure and all incisions are closed so an open casket funeral can take place. After the organs have been removed, the patient is taken off artificial support.

While organs must be used between 6 and 72 hours after removal from the donor’s body (depending on the organ), tissues such as corneas, skin, heart valves, bone, tendons, ligaments, and cartilage can be preserved and stored in tissue banks for later use.

Donation after cardiac death (DCD)

Some patients that have sustained traumatic brain injury cannot be declared dead based on the definition of brain death. In these cases, the patient is declared dead upon cardiac death, which is the cessation of cardiac and respiratory function when the patient is withdrawn from life support.

Donation after cardiac death occurs only after the patient or family has decided to withdraw life-sustaining therapies for reasons entirely apart from any potential for organ donation.

Whole body donation

People who wish to donate their entire body to medical science should contact the medical school or willed body program of their choice and make arrangements to do so before they die. Medical schools need bodies to teach medical students about anatomy, and research facilities need them to study disease processes so they can devise cures. Since the bodies used for these purposes generally must be complete with all their organs and tissues, organ donation is not an option. Some programs, however, make exceptions. You can inform your family that organ donation is your first choice, but if it is found that you are not medically suitable for organ donation, your family can carry out your wishes for whole body donation.

Source: www.OrganDonor.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.OrganDonor.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

 

 

Disaster Preparedness, Make a Plan/Practice the Plan

Is your facility, your family, and your staff ready for a disaster? With the devastation of Katrina and Rita, many people have been left wondering if they are truly prepared for a disaster of that magnitude. Obviously, we have few hurricanes here in the Northwest however all Oregonians are at risk of suffering the devastation that can occur in an earthquake. It is not a matter of if but when and unlike hurricanes, earthquakes give no advance warning of attack.

The question to ask yourself is if an earthquake occurred today and shut down communication and resources, could you safely care for the sick and now possibly newly injured residents for up to 72 hours with the staff you have on hand? Put your plan on paper and have your facility practice a mock drill within the facility. Make the plan realistic enough to arm your staff with the ability to make good decisions that keep residents safe and the staff encouraged to stay and help. To keep employees concentrated on their tasks it is important for them to understand their role in an emergency. The City of Portland recommends that you create a Fire/Life Safety Team comprised of a Safety Director, Building Response Team, Floor Wardens, and Assistant Monitors. This safety team handles all emergencies and is armed with duties that are pre-determined and practiced.

Every facility has practiced a fire drill and handling a disaster situation is much the same. The additional challenge in an earthquake is that there may be other emergencies that occur secondary to the earthquake like fires, exposure to gas fumes etc. You need an educated team ready to respond to these emergencies that are trained and able to lead the others through an intense event. There is an old saying “knowledge is power” and I suggest you give your staff the power to deal with any emergency. To receive a thorough package of how to prepare for a variety of emergencies contact your local fire department.

To help your employees and their families prepare for a disaster contact your local Red Cross and ask for information about protecting their homes and preparing disaster kits. Many employees are more apt to stay at work if they know their families have prepared for such an incident.

We have seen the devastation, we have seen the unprepared, don’t wait to see if you are ready. Make a plan!

American Medical Response is the largest ambulance company in the United States and supplied 220 emergency workers and over 80 ambulances from across the nation to those affected by Katrina. I would like to applaud all of these emergency workers for their dedication to serving others, I would also like to applaud AMR who went the extra mile to assure the families of those affected by Katrina and those that went to help were well taken care of during this time. They had a plan and it worked.

Source: Sarah Ross, American Medical Response Northwest, PO Box 15339, Portland, OR 97293-5339, www.amr.net
Posted April 2008. Markets: Oregon, Portland, Salem

Provided by: American Medical Response
For more information: www.amr.net, 503-793-8240
Copyright © 2008 RetirementConnection.com. All rights reserved.

Dental Care Every Day: A Caregiver’s Guide

As a caregiver, you play an important role in maintaining the oral health of your client or family member. Helping someone with brushing and flossing, however, isn’t always easy. But there are steps you can take to make daily dental care a good experience. The key ingredients are patience and preparation: pick a place in the house where the person is comfortable; allow time for him or her to adjust to the dental care; have a set routine; and reward cooperation. Remember, a healthy mouth can make a big difference in the quality of life for the person in your care.

Taking care of someone with a developmental disability requires patience and skill. As a caregiver, you know this as well as anyone does. You also know how challenging it is to help that person with dental care. It takes planning, time, and the ability to manage physical, mental, and behavioral problems. Dental care isn’t always easy, but you can make it work for you and the person you help. This booklet will show you how to help someone brush, floss, and have a healthy mouth.

Everyone needs dental care every day. Brushing and flossing are crucial activities that affect our health. In fact, dental care is just as important to your client’s health and daily routine as taking medications and getting physical exercise. A healthy mouth helps people eat well, avoid pain and tooth loss, and feel good about themselves.

Getting Started

Location. The bathroom isn’t the only place to brush someone’s teeth. For example, the kitchen or dining room may be more comfortable. Instead of standing next to a bathroom sink, allow the person to sit at a table. Place the toothbrush, toothpaste, floss, and a bowl and glass of water on the table within easy reach.

No matter what location you choose, make sure you have good light. You can’t help someone brush unless you can see inside that person’s mouth. Positioning your body lists ideas on how to sit or stand when you help someone brush and floss.

Behavior

Problem behavior can make dental care difficult. Try these ideas and see what works for you.

* At first, dental care can be frightening to some people. Try the “tell-show-do” approach to deal with this natural reaction. Tell your client about each step before you do it. For example, explain how you’ll help him or her brush and what it feels like. Show how you’re going to do each step before you do it. Also, it might help to let your client hold and feel the toothbrush and floss. Do the steps in the same way that you’ve explained them.
* Give your client time to adjust to dental care. Be patient as that person learns to trust you working in and around his or her mouth.
* Use your voice and body to communicate that you care. Give positive feedback often to reinforce good behavior.
* Have a routine for dental care. Use the same technique at the same time and place every day. Many people with developmental disabilities accept dental care when it’s familiar. A routine might soothe fears or help eliminate problem behavior.
* Be creative. Some caregivers allow their client to hold a favorite toy or special item for comfort. Others make dental care a game or play a person’s favorite music. If none of these ideas helps, ask your client’s dentist or dental hygienist for advice.

Three Steps to a Healthy Mouth

Like everyone else, people with developmental disabilities can have a healthy mouth if these three steps are followed:

1. Brush every day.
2. Floss every day.
3. Visit a dentist regularly.

Step 1. Brush Every Day

Angle the brush at the gumline and brush gently. If the person you care for is unable to brush, these suggestions might be helpful.

* First, wash your hands and put on disposable gloves. Sit or stand where you can see all of the surfaces of the teeth.
* Be sure to use a regular or power toothbrush with soft bristles.
* Use a pea-size amount of toothpaste with fluoride, or none at all. Toothpaste bothers people who have swallowing problems. If this is the case for the person you care for, brush with water instead.
* Brush the front, back, and top of each tooth. Gently brush back and forth in short strokes.
* Gently brush the tongue after you brush the teeth.
* Help the person rinse with plain water. Give people who can’t rinse a drink of water, or consider sweeping the mouth with a finger wrapped in gauze.
* Get a new toothbrush with soft bristles every 3 months, after a contagious illness, or when the bristles are worn.
* If the person you care for can brush but needs some help, the following ideas might work for you. You may think of other creative ways to solve brushing problems based on your client’s special needs.

Make the Toothbrush easier to hold.

* The same kind of Velcro® strap used to hold food utensils is helpful for some people.
* Others attach the brush to the hand with a wide elastic or rubber band. Make sure the band isn’t too tight.
* Make the toothbrush handle bigger.
* You can also cut a small slit in the side of a tennis ball and slide it onto the handle of the toothbrush.
* You can buy a toothbrush with a large handle, or you can slide a bicycle grip onto the handle. Attaching foam tubing, available from home health care catalogs, is also helpful.
* Try other toothbrush options.
* A power toothbrush might make brushing easier. Take the time to help your client get used to one.
* Guide the Toothbrush
* Help brush by placing your hand very gently over your client’s hand and guiding the toothbrush. If that doesn’t work, you may need to brush the teeth yourself.

Step 2. Floss Every Day

Flossing cleans between the teeth where a toothbrush can’t reach. Many people with disabilities need a caregiver to help them floss. Flossing is a tough job that takes a lot of practice. Waxed, unwaxed, flavored, or plain floss all do the same thing. The person you care for might like one more than another, or a certain type might be easier to use.

* Use a string of floss 18 inches long. Wrap that piece around the middle finger of each hand.
* Grip the floss between the thumb and index finger of each hand.
* Start with the lower front teeth, then floss the upper front teeth. Next, work your way around to all the other teeth.
* Work the floss gently between the teeth until it reaches the gumline. Curve the floss around each tooth and slip it under the gum. Slide the floss up and down. Do this for both sides of every tooth, one side at a time.
* Adjust the floss a little as you move from tooth to tooth so the floss is clean for each one.
* If you have trouble flossing, try using a floss holder instead of holding the floss with your fingers.
* The dentist may prescribe a special rinse for your client. Fluoride rinses can help prevent cavities. Chlorhexidine rinses fight germs that cause gum disease. Follow the dentist’s instructions and tell your client not to swallow any of the rinse. Ask the dentist for creative ways to use rinses for a client with swallowing problems.

Positioning Your Body: Where To Sit or Stand

* Keeping people safe when you clean their mouth is important. Experts in providing dental care for people with developmental disabilities recommend the following positions for caregivers. If you work in a group home or related facility, get permission from your supervisor before trying any of these positions.
* If the person you’re helping is in a wheelchair, sit behind it. Lock the wheels, then tilt the chair into your lap.
* Stand behind the person or lean against a wall for additional support. Use your arm to hold the person’s head gently against your body.

Step 3. Visit a Dentist Regularly

* Your client should have regular dental appointments. Professional cleanings are just as important as brushing and flossing every day. Regular examinations can identify problems before they cause unnecessary pain.
* As is the case with dental care at home, it may take time for the person you care for to become comfortable at the dental office. A “get acquainted” visit with no treatment provided might help: The person can meet the dental team, sit in the dental chair if he or she wishes, and receive instructions on how to brush and floss. Such a visit can go a long way toward making dental appointments easier.

Prepare for Every Dental Visit: Your Role

* Be prepared for every appointment. You’re an important source of information for the dentist. If you have questions about what the dentist will need to know, call the office before the appointment.
* Know the person’s dental history. Keep a record of what happens at each visit. Talk to the dentist about what occurred at the last appointment. Remind the dental team of what worked and what didn’t.
* Bring a complete medical history. The dentist needs each patient’s medical history before treatment can begin. Bring a list of all the medications the person you care for is taking and all known allergies.
* Bring all insurance, billing, and legal information. Know who is responsible for payment. The dentist may need permission, or legal consent, before treatment can begin. Know who can legally give consent.
* Be on time.

Remember…

* Brushing and flossing every day and seeing the dentist regularly can make a big difference in the quality of life of the person you care for. If you have questions or need more information, talk to a dentist.

Source: The National Institute of Dental and Craniofacial Research. www.nidcr.nih.gov

Expert Review Panel: Mae Chin, RDH, University of Washington, Seattle, WA, Sanford J. Fenton, DDS, University of Tennessee, Memphis, TN, Ray Lyons, DDS, New Mexico Department of Health, Los Lunas, NM, Christine Miller, RDH, University of the Pacific, San Francisco, CA, Steven P. Perlman, DDS, Special Olympics Special Smiles, Lynn, MA, David Tesini, DMD, Natick, MA

Provided by: The Staff at www.RetirementConnection.com
For more information: www.nidcr.nih.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Costs of Long-term Care

An important part of planning for long-term care is deciding how to pay for services. This is because long-term care is very expensive, and contrary to what many people believe, their Medicare coverage will not pay for most of the long-term care services they need. While some people may qualify for Medicaid – the major payer of long-term care services, most people won’t. There are other federal public programs, such as the Older American’s Act, or state funded programs, that pay some long-term care services, but like Medicaid they target those people with the most functional and financial need. Consequently, if you are one of the 60% of people over the age of 65 who will need long-term care services – there’s a very good chance you will have to pay for some or all of your long-term care services out of your personal income and resources.

Paying for long-term care out of your personal income and resources can be challenging. Even if you have a modest need for assistance at home with personal care, say a visit from a home health aide 3 times a week, based on 2007 average costs, you would have to pay about $16,000 a year for those services.

To make the best decisions about how to pay for long-term care you need to understand what services cost, what public programs you are eligible for and what they cover, what private financing options are available, and which ones work best for you.

What Does Long-Term Care Cost?

LTC includes a broad range of health and support services that people need as they age or if they are disabled. The majority of these services are personal care, or assistance with activities of daily living that many families are able to provide all, or some of, free. But, as care and support needs increase, paid care is usually needed to supplement family provided services and supports, provide respite to family caregivers, or to pay for more extensive services in a facility, such as a nursing home or assisted living, when individuals can no longer be cared for in their homes.

There are variations in costs based on the type and amount of care you need, the provider you use, and where you live. Home health and home care services, provided in two-to-four-hour blocks of time referred to as “visits,” are generally more expensive in the evening, or on weekends or holidays. The costs of services in some community programs, such as adult day service programs, are often provided at a per-day rate, but vary based on overhead and programming costs. Many care facilities charge extra for services provided beyond the basic room-and-board charge, although some may have “all inclusive” fees.

The average costs in the United States (in 2007) are:

* $181/day for a semi-private room in a nursing home
* $205/day for a private room in a nursing home
* $2,714/month for care in an Assisted Living Facility (for a one-bedroom unit)
* $25/hour for a Home Health Aide
* $17/hour for a Homemaker services
* $61/day for care in an Adult Day Health Care Center

Who Pays for Long-Term Care?

If you have sufficient income and assets, you are likely to pay for your long-term care needs on your own, out of those private resources. If you meet functional eligibility criteria and have limited financial resources, or deplete them paying for care, Medicaid may pay for your care. If you require primarily skilled or recuperative care for a short time, Medicare may pay. The Older Americans Act is another Federal program that helps pay for long-term care services. Some people use a variety of payment sources as their care needs and financial circumstances change.

National Spending on Long-Term Care

The total amount spent on long-term care services in the United States (in 2005) was $206.6 billion. This does not include care provided by family or friends on an unpaid basis (often called “informal care.”) It only includes the costs of care from a paid provider.

While most information on “who pays for long-term care” presents these national figures, it is important to remember that each person’s individual experience will differ. These figures combine the experiences of everyone receiving paid care, but there are significant variations from person to person.

On an aggregate basis, the biggest share, 49 percent, is paid for by Medicaid. On an individual basis, however, “who pays for long-term care” can look very different. This is because people with their own personal financial resources do not qualify for Medicaid unless they use up their resources first paying for care, so-called “spending down”. If you have reasonable income and assets, most likely you will be paying for care on your own.

Also, while Medicare overall pays for 20 percent of long-term care, it only pays under specific circumstances. If the type of care you need does not meet Medicare’s rules, Medicare will not pay and you are likely to pay for your care on your own.

Learning more about the “rules” for when Medicare, Medicaid, other public programs or private insurance might pay for long-term care is an important part of understanding “who will pay” if and when you need care.

Source: www.LongTermCare.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.LongTermCare.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

How to Cope with Caregiver Stress

Two-thirds of caregivers in the United States work outside of the home. This creates a unique challenge for both working caregivers and their employers. Juggling caregiving and work-related responsibilities is not easy and some caregivers find it necessary to turn down job opportunities, quit their jobs, or take early retirement. Employers face the costs of replacing valuable employees. By working together, employees and employers can create a workplace environment that is productive and meets everyone’s needs.

Below you will find information on how to cope with the stress and emotions related to caregiving and suggestions on how you can better balance caregiving and work responsibilities.

Caregiver Stress

By developing some coping strategies, you may be able to avoid reaching the point of exhaustion and burnout. You are experiencing burnout if you become numb to your loved one’s needs and feelings and you just don’t care. Don’t let it go that far; it may be difficult or impossible to recover.

* Remember you are not alone.
* Seek out resources that can assist you during this emotionally stressful time (books, organizations, web pages, and support groups).
* Find an Eldercare Specialist, a trained expert, who can help you find the services and support you need.

Caregiver Emotions

Providing care for someone you love who is no longer able to take care of him- or herself produces a wide range of emotions. It’s natural to feel sadness and grief for your loved one’s losses and for the loss of your own previous life. Over time, more emotions may surface.

You may have days when you feel:

* Angry and resentful
* Guilty and impatient
* Ashamed and lonely
* Sorry for yourself
* Fearful of the future

Some of these may shock you or seem “bad.” These feelings aren’t self-centered or wicked. It is a normal response to the extreme changes that providing care can bring to your life.

As a caregiver, you donate a great deal of your time and energy to someone else’s needs, and often ignore your own. When difficult emotions surface, remember that you have your own needs. Let your feelings prompt you to do something for yourself. Take a break: watch the birds, read a magazine, listen to a favorite song, or just meditate.

Reactions To Loss And Change

There are many losses as one deals with change. Recognizing these will help one address them.

* Guilt
* Sadness
* Anxiety
* Withdrawal
* Irritability
* Feeling overwhelmed
* Anger/frustration
* Feeling helpless
* Change in appetite

Steps For Coping With Loss

* Talk about your feelings: Reach out to others (friends, family, spiritual leaders) – this will help reduce feelings of isolation.
* Join a support group: Support groups provide caregivers with the opportunity to share with other caregivers and learn from one another.
* Write your feelings down: For people who enjoy writing, this can be a wonderful way to express feelings.
* Read a book on coping with grief: There are several books available on the issues of caregiving, grieving and loss
* Get help when needed: Professionals are available and a third party analyzing the situation can be a reliable ally. The Internet is another resource for finding help nationally and in your community. The U.S. Administration on Aging’s Eldercare Locator (1-800-677-1116) can connect you to services in your community.

Work and Caregiving: Finding The Balance

* Prioritize your time at home and at work. Keeping a calendar of activities helps to identify priorities.
* Learn to delegate. Share your responsibilities with others. Do not be afraid to ask for help. It is not a sign of weakness.
* Help your company recognize your needs and the needs of other employed caregivers.
* Keep communication channels open with your supervisor or your Human Resource department.
* Utilize your company’s available resources. Remember that businesses want and need to keep good workers. They want to provide support for their employees.
* Use your vacation time and make sure the time is spent nurturing you.
* Make time for you. Do what works for you. Spend time with friends, family members, or participate in a group. Spend time alone. Plant a garden, go for long walks, read, take a hot aroma therapy bath. Do whatever it takes to nurture yourself. Always include doing things that are important to you.

Source: www.aoa.gov, St. Andrew’s Caring Workplace, St. Louis, MO., www.caringworkplace.com

Provided by: The Staff at www.RetirementConnection.com
For more information: www.aoa.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Baby Boomers Face Reality of Planning For Two

This year marks a historic benchmark in America’s aging population as Baby Boomers begin turning 60. Baby Boomers are expected to live longer than any previous generation of Americans.

Baby Boomers are those adults who were born between 1946 and 1964, a period of increased birth rate during America’s economic prosperity following World War II. Of the 3.4 million Baby Boomers born in 1946, 2.8 million are still alive. Some of America’s more famous Boomers who’ll turn 60 this year: Bill Clinton, George and Laura Bush, Donald Trump, Susan Sarandon, Steven Spielberg and Sylvester Stallone.

As Baby Boomers begin planning their lives after leaving the workforce, a growing number of them now face the additional challenge of finding care for their aging parents at the same time, because Americans are living longer. In many cases, a Baby Boomer who is now 60 has parents who are 80 or older.

Medical advancements are part of the reason people are living longer, into their 80s, 90s and even 100s. These longer lives can mean the development of chronic conditions, such as arthritis and diabetes, Alzheimer’s disease or Parkinson’s disease in Baby Boomers’ parents. These conditions make it difficult for these parents to perform some or many daily activities.

At a time when most Baby Boomers are concerned about their own retirement, many also are faced with the fact that they have parents who are reaching a level where they need some type of care and assistance. It’s a situation that will continue to grow as the Baby Boomers age.

As the parents of Baby Boomers advance in age, their families will experience a “parenting the parent” situation, where adult children, who may be in their 50s or 60s, become primary caregivers.

Baby Boomers who face the reality of caring for their adult parents are discovering:

* Retirement, a time typically associated with relaxation and less stress, becomes more stressful because of the additional caregiving responsibility;
* A need now exists for greater financial planning, both for the Baby Boomers and their aging parents; and
* There are now greater demands on the time of Baby Boomers to care for their aging parents, often meaning families need to bring in outside resources.

It’s very stressful for anyone to care for aging parents. We now have an entire generation, one of the largest generations ever, facing that challenge. The good news is that help is available to aid families in providing care for seniors, and that Baby Boomers are becoming better educated on the issues of aging.

Source:Right at Home Managing, www.RAHcares.com 503 574 3674
For more information: www.RAHcares.com, 503-574-3674

Copyright © 2008 RetirementConnection.com. All rights reserved.

Caregiver Stress & Elder Abuse

Most people who need help with daily activities as a result of a disabling condition or illness get the care they need from family members or friends. Some receive help from paid caregivers who work for agencies or independently. Despite the significant physical and emotional demands of providing care, the overwhelming majority of caregivers are meeting the challenge; many are doing an excellent job. But reports of abuse by caregivers are not uncommon and appear to be on the rise. This fact sheet responds to frequently asked questions about caregiver stress and abuse.

What is a caregiver?

The term refers to anyone who routinely helps others who are limited by chronic conditions. “Formal” caregivers are volunteers or paid employees connected to the social service or health care systems. The term “informal caregiver” refers to family members and friends, who are the primary source of care for nearly three-quarters of the impaired older adults who live in the community. Caregivers assist with such basic tasks as bathing, dressing, preparing meals and shopping. Some have the added responsibilities of administering medications, making sure that an immobile person is turned frequently to avoid developing pressure sores, and other tasks related to the older person’s illness or disability.

How large a problem is abuse by caregivers?

Although it is known that in 90% of all reported elder abuse cases, the abuser is a family member, it is not known how many of these abusive family members are also caregivers. Researchers have estimated that anywhere from five to twenty-three percent of all caregivers are physically abusive. Most agree that abuse is related to the stresses associated with providing care.

What is caregiver stress and why is it harmful?

Stress is often described as the body’s “fight or flight” response to danger. When the body goes on “high alert” to protect itself, essential functions, like respiration and heart rate, speed up, while less essential functions, such as the immune system, shut down. Although the stress response is a healthy reaction, the body needs to repair itself once danger is removed. For caregivers, whose stress often results from fatigue and conflicts that never go away, their bodies never get a chance to heal. If the immune system isn’t functioning fully, the caregiver is at greater risk for infections and disease. Some experts believe that stress causes hypertension, coronary disease or even premature death.

Do all caregivers experience stress?

Some stress is normal. In the past, it was believed that the more care a person provided, the more likely she was to experience stress. Now it is known that not all caregivers are created equal. Some, who provide high levels of care, experience no stress, while others who provide relatively little care experience high levels of stress. Many experts believe that these differences can be explained by subjective factors such as how caregivers feel about providing care, their current and past relationships to those they care for, and their coping abilities. Some caregivers find certain behaviors by care receivers to be particularly stressful, including aggression, combativeness, wandering and incontinence. Others report that they experience stress because they don’t get enough rest, privacy, support or time for themselves.

Are all “stressed caregivers” at risk for becoming abusive?

It is true that some of the same factors that are believed to cause caregiver stress also raise the risk of abuse. For example, when the relationship between a caregiver and care receiver was poor to begin with, the caregiver is more likely to feel stress and to become abusive. But the link between caregiver stress and abuse is not yet fully understood, and more research is needed to understand what factors predict or contribute to caregiver abuse. Specific areas that need to be explored include how aggression by care receivers raises the risk of abuse, why some caregivers fear that they will become abusive, whether caregivers who are afraid of becoming abusive are more likely to actually abuse, and how caregivers’ coping patterns play a role.

Are there “red flags” to watch for?

Drawing from what is currently known about caregiver abuse, the following factors may be cause for concern:

The caregiver:

* Fears that he will become violent
* Suffers from low self esteem
* Perceives that she is not receiving adequate help or support from others
* Views caregiving as a burden
* Experiences emotional and mental “burnout,” anxiety or severe depression
* Feels “caught in the middle” by providing care to children and elderly family members at the same time
* Has “old anger” toward the care receiver that can be traced back to their relationship in the past

The care receiver:

* Is aggressive or combative
* Is verbally abusive
* Exhibits disturbing behaviors such as sexual “acting out” or embarrassing public displays

The caregiver and the care receiver:

* Live together
* Had a poor relationship prior to the onset of the illness or disabling condition
* Are married and have a marital relationship that is characterized by conflict

What can be done?

* Reducing the risk of elder abuse by caregivers will require the efforts of caregivers, agencies and the community.

Caregivers can:

* Get help. Making use of social and support services, including support groups, respite care, home delivered meals, adult day care and assessment services, can reduce the stress associated with abuse.
* Learn to recognize their “triggers,” those factors that cause them the greatest stress or anxiety.
* Learn to recognize and understand the causes of difficult behaviors and techniques for handling them more effectively.
* Develop relationships with other caregivers. Caregivers with strong emotional support from other caregivers are less likely to report stress or to fear that they will become abusive.
* Get healthy. Exercise, relaxation, good nutrition and adequate rest have been shown to reduce stress and help caregivers cope.
* Hire helpers. Attendants, chore workers, homemakers or personal care attendants can provide assistance with most daily activities. Caregivers who cannot afford to hire helpers may qualify for public assistance.
* Plan for the future. Careful planning can relieve stress by reducing uncertainty, preserving resources and preventing crises.A variety of instruments exist to help plan for the future including powers of attorney, advanced directives for health care, trusts and wills.

Agencies can:

* Carefully screen caregivers and patients for the risk factors associated with caregiver abuse.
* Provide caregivers with information and support to lower their risk.
* Provide instruction to caregivers (though materials, classes, websites or support groups) in conflict resolution and how to deal with difficult behaviors such as violence, combativeness and verbal abuse.
* Promote better coordination between agencies that offer protection to victims and those that offer services to caregivers. This can be achieved through cross-disciplinary training, interagency protocols and multidisciplinary teams.

Concerned citizens can:

* Lend a hand to a caregiver who needs help.
* Report abuse. In most communities, Adult Protective Services (APS) is the agency that accepts and investigates reports. Look in the city or county government section of the telephone directory under “Aging Services” or “Social Services,” or contact local Area Agencies on Aging.
* Advocate for public policy to increase the supply and scope of services available to caregivers.
* Volunteer. Volunteers can make friendly visits, serve as guardians or bill payers, or provide respite care.
* Arrange to have speakers make presentations on caregiving at churches, clubs or civic organizations.

To lean more about elder abuse and how to report it:

The National Center on Elder Abuse
http://www.ncea.aoa.gov/

National Committee for the Prevention of Elder Abuse
http://www.preventelderabuse.org

To find out about services in your community: Area Agencies on Aging (AAA) provide or coordinate services for the elderly and their families. They also provide information on a variety of issues of concern to the elderly and caregivers, and help seniors and their families gain access to services. Look in the city or county government section of the telephone directory under “Aging Services” or “Social Services.” You can also get the number from the Eldercare Locator at (800) 677-1116.

Source: Institute on Aging for the National Center on Elder Abuse. www.ncea.aoa.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.ncea.aoa.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Caring For Family Caregivers

Right at Home Offers Practical Tips for Preventing Caregiver Burnout

Taking care of an aging loved one is never easy – especially when most family caregivers juggle caregiving with other major responsibilities, including careers and children.

In fact, according to the National Alliance for Caregiving and AARP, an estimated 52 million Americans age 18 and older provide unpaid assistance and support to elderly or disabled adults.

“Family caregivers can be so concerned with taking care of others, that they lose sight of their own health and well being,” said Rob MacNaughton of the East Portland Right at Home office. “It is important to recognize that when your needs are taken care of, the person you care for will benefit as well.”

Below, Right at Home provides some practical tips for individuals coping with the emotional and physical challenges of caring for an aging or disabled loved one:

1. EXERCISE – Embrace exercising, as it will help you decrease stress and enhance your level of energy. Most experts recommend at least 30 minutes, three times a week.
2. EAT BALANCED MEALS – Eat plenty of vegetables, fresh fruits, whole grains and foods high in protein. Try to avoid excess amounts of caffeine, fast food and sugary snacks.
3. BE INFORMED – Learn everything you need to know about your loved one’s illness in order to be a good caregiver. Knowing what you’re up against and what you may expect can give you a sense of control over your situation. Websites and local offices of disease-specific associations such as the Alzheimer’s association or Parkinson’s Foundation provide a wealth of empowering information.
4. SEEK RESPITE CARE – Respite provides family caregivers with a much needed break from their daily responsibilities. Respite care could include assistance from a bonded and insured in-home caregiving agency (such as Right at Home), utilization of an adult daycare center, or even help from other family members or friends. With respite care, you can feel safe leaving your loved one while you run errands or just relax. More extensive respite care can allow you to continue working outside your home or help you balance caring for your children and an elderly adult.
5. TAKE CARE OF YOUR PERSONAL HEALTH – While concentrating on the needs of others is important, it is easy to neglect your own health. Get regular health checkups and make sure you are getting enough sleep.
6. JOIN A SUPPORT GROUP – A support group will allow you to share your experiences openly and honestly about being a family caregiver, along with the emotions you are feeling. Communicating with other caregivers can give you helpful tips and strategies, relieving that overwhelming sense of isolation that many caregivers face daily. Your local Area Agency on Aging or your local senior center, are good places to start gathering information on groups in your area.
7. REMEMBER FRIENDS AND FAMILY – Just because you have aging parents who need your help doesn’t mean that your children, spouse or close friends do not need attention as well. Discuss the situation openly and honestly with the family, engaging them in caregiving responsibilities if possible.
8. ACCEPT YOUR FEELINGS – Develop coping skills and stay positive. Make humor a part of your life – laughter is the best medicine!

For more information on support for the family caregiver, download a free copy of the 2007 Adult Caregiving Show Me Guide at www.rightathome.net and check out the following organizations:

* AARP’s Caregiver Support
www.aarp.org/families/caregiving
Phone: (888) 687-2277
* Family Caregiver Alliance
www.caregiving.org
Phone: (800) 445-8106
* In Home Care & Assistance – Right at Home
www.rightathome.net
Phone: (877) 697-7537
* Secure Horizons
www.ilivesecure.com
Phone: (866) 397-3962
* National Association of Area Agencies on Aging
www.n4a.org
Phone: (202) 872-0888
* National Family Caregivers Association
www.nfcacares.org
Phone: (800) 896-3650

Source: Right at Home Managing Director, www.RAHcares.com 503 574 3674

Provided by: Right at Home Managing Director
For more information: www.RAHcares.com, 503-574-3674

Copyright © 2008 RetirementConnection.com. All rights reserved.

Challenges of Global Aging,  and The Administration on Aging

The Administration on Aging (AoA), an agency in the U.S. Department of Health and Human Services, is one of the nation’s largest providers of home and community-based care for older persons and their caregivers. Our mission is to promote the dignity and independence of older people, and to help society prepare for an aging population.

Global Aging

The United States is faced with profound challenges associated with dramatic increases in the numbers of people living to an advanced old age. This 21st Century phenomenon, shared by many nations, can be attributed to advances in science, technology and medicine leading to reductions in infant and maternal mortality, infectious and parasitic diseases, occupational safety measures, and improvements in nutrition and education.

Rapidly expanding numbers of very old people represent a social phenomenon without historical precedent. In 2000, the number of persons aged 60 years or older was estimated at 605 million. That number is projected to grow to almost 2 billion by 2050, when the population of older persons will be larger than the population of children (0-14 years) for the first time in human history.¹

Fifty-four percent, the largest share of the world’s older persons, live in Asia. Europe has the next largest share, with 24 percent.²

Challenges of Global Aging

Population ageing will affect every man, woman and child anywhere in the world. The steady increase of older age groups will have a direct bearing on relationships within families, equity across generations, lifestyles, and the family solidarity that is the foundation of society.³

For More Information

AoA recognizes the importance of making information readily available to consumers, professionals, researchers, and students. Our website provides information for and about older persons, their families, and professionals involved in aging programs and services. For more information about AoA, please our website at www.aoa.gov.

U.S. Administration on Aging International Activities

As the federal focal point for older Americans and their caregivers, the Administration on Aging (AoA) plays a vital role in information exchange with other nations concerning aging issues. The AoA participates in a number of collaborative efforts with foreign governments and with international organizations, such as the United Nations, to enhance aging programs and policies worldwide.

* Empowering adults as they age with reliable information and access to the care they need
* Enabling individuals who are at high risk of nursing home placement to remain at home
* Building disease prevention into community living through the use of low-cost, evidence based programs

We respond to requests for information from international organizations, foreign governments, and non-profit agencies. We host international scholars, officials and practitioners who come to the United States to learn first-hand about America’s response to population aging.

People’s Republic of China Agreement

The AoA and the China National Committee on Ageing of the People’s Republic of China have agreed to share information and to develop collaborative activities.

The U.S.-Mexico Binational Commission

The AoA is especially committed to working with neighboring countries. In 1996, a Health Working Group was established under the auspices of the U.S.-Mexico Binational Commission, which promotes exchanges at the Cabinet level on a wide range of issues critical to U.S.-Mexico relations. The Aging Core Group, led in the U.S. by the Assistant Secretary for Aging, is one of six areas of collaboration between the U.S. Department of Health and Human Services and the Mexican Ministry of Health.

Ongoing exchanges of information, and shared training and technical assistance will help both countries to better address the special health needs of older people. Examples of such treatable medical conditions are depression, nutritional deficiencies, adverse drug interactions, and metabolic changes.

Specific areas of collaboration include:

* Models of care for the elderly;
* Nutrition and the elderly; and
* Prevention and control of chronic disease in the elderly

Implementation of The International Plan of Action on Ageing

On April 12, 2002, the World Assembly on Ageing adopted the International Plan of Action on Ageing 2002 (the “Plan”). This Plan seeks to ensure that people everywhere will age with security and dignity, and continue to participate in their societies as citizens with full rights. The top priorities include involving older persons in the development process; advancing health and well being into old age; and ensuring supportive environments that enable older persons to have choices. Core themes included the recognition of the needs of older women; the desire of older people to stay active and engaged; and the need to create intergenerational solidarity. These themes demonstrate how the international community shares a common vision of a better future for older persons. Leading the U.S. delegation, the Assistant Secretary for Aging, Josefina G. Carbonell, affirmed the U.S. commitment to the these themes. The AoA, working in concert with other nations, will play a key role in implementing the Plan.

For More Information

AoA recognizes the importance of making information readily available to consumers, professionals, researchers, and students. Our website provides information for and about older persons, their families, and professionals involved in aging programs and services. For more information about AoA, please contact: US Dept of Health and Human Services, Administration on Aging, Washington, DC 20201; phone (202) 619- 0724; fax (202) 357-3523; Email: aoainfo@aoa.gov or contact our website at www.aoa.gov.

Source: US Dept of Health and Human Services, Administration on Aging, www.aoa.gov
1Sources: An Aging World 2001, U.S. Department of Commerce, UN Department of Public Information, DP/2264, March 2002.
2Sources: An Aging World 2001, U.S. Department of Commerce, UN Department of Public Information, DP/2264, March 2002.
3Sources: An Aging World 2001, U.S. Department of Commerce, UN Department of Public Information, DP/2264, March 2002.

Provided by: The Staff at www.RetirementConnection.com
For more information: www.AoA.gov

Copyright © 2008 RetirementConnection.com. All rights reserved.

Checkups, Tests and Shots

The Agency for Healthcare Research and Quality has developed The Pocket Guide to Staying Healthy at 50+. The guide is available online or you may order copies of the guide from their website. The guide contains valuable health information on many topics for older adults 50+. Consider these suggestions:

Checkups, Tests, and Shots – Which Ones You Need and When To Get Them

* Checkups and tests, such as vision tests or cholesterol tests, help find diseases or conditions early, when they are easier to treat. Shots (immunizations) protect you from different diseases.
* The Pocket Guide to Staying Healthy at 50+ contains a section that gives the 50+ adult information on why and when you may need different checkups, tests, and shots.

Dental, Hearing, and Vision Care

* “I keep better track of when my pets need their checkups than when I need checkups myself. I can’t seem to remember the next time I need to visit the dentist or get my eyes checked. So I’ve started to ask my dentist and doctor when I need my next appointment. I write it down in my Pocket Guide to Staying Healthy at 50+.” – Narong P.
* Getting the checkups you need for your teeth and gums, vision, and hearing is an important part of your health care. The Pocket Guide to Staying Healthy at 50+ contains a section that tells the 50+ adult how to take care of your teeth and gums and how to decide whether you need a hearing and vision checkup.

Teeth and Gums

The Pocket Guide to Staying Healthy at 50+ contains some simple tips to follow for dental health such as:

* Visit your dentist once or twice a year for checkups.
* Brush after meals with a toothbrush that has soft or medium bristles.
* Use toothpaste with fluoride.
* Use dental floss every day.
* Eat fewer sweets, especially between meals.

The Pocket Guide to Staying Healthy at 50+

For the a copy of the complete Pocket Guide to Staying Healthy at 50+ visit this web link:
http://www.ahrq.gov/ppip/50plus/

Source: The Agency for Healthcare Research and Quality, www.ahrq.com

Provided by: The Staff at www.RetirementConnection.com
For more information: www.ahrq.gov/ppip/50plus/
Copyright © 2008 RetirementConnection.com. All rights reserved.