Caregiver Registries, In-Home Care Agencies and Non-Profit Listing Services/Classifieds?

What is a Caregiver Registry?
A registry is a broker service that matches independent caregivers to consumers. In this model, the consumer selects and hires the caregiver directly for a referral fee, which may be ongoing, temporary, or a one-time, up-front fee.

Here’s how it works: the consumer contacts the registry with a general description of their care giving needs…. such as meals, bathing, errands, medication assistance, etc.  and may also request more specific characteristics such as “middle-years female with cooking skills,” “a good sense of humor,” “experience with end-of-life care,”  etc. Other features of the registry model:

• Called “consumer-directed care,” the consumer interviews and selects the caregiver candidates from a pool of pre-screened candidates
• Caregivers generally earn a higher percentage of the total fee than employer-based models because operational expenses are simpler
• Consumers (or their representatives) and caregivers control all terms together independent from the registry-ie compensation, scheduling, duties, etc.
• The registry must adhere to independent contractor guidelines; it may not assess the client or supervise the caregivers; rather, it gathers basic information for matching purposes, acting as a “repository of information” between caregivers and clients
• The registry may not end the service unilaterally, though that does not mean that a referral fee is not owed
• Consumers are generally viewed as the employer of the caregiver and may be responsible for payroll taxes
• Worker’s compensation is not provided by the registry and consumers are not required to carry it on their caregivers in Oregon
• Caregivers MAY be bonded and/or liability-insured but it may also be just the registry that is, which costs a fraction of covering the caregivers themselves; thus it is prudent to ask for proof of bonding/insurance on the individual caregivers
• Once the referral has been made, caregivers and clients decide how duties will be performed-no agency restrictions
• Caregiver Registries are now licensed by the State of Oregon, as of 2011; Caregiver Connection, Inc. is the first to be licensed in Oregon; there are 3 seeking licensure in the Portland-Metro area.

What is an In-Home Care Agency?
An In-Home Care Agency are services that employ its caregivers. In this model, the agency directs the actions of the caregiver-it assess the consumers’ needs and supervises the caregivers.

• Called “agency-directed care,” duties and compensation are determined by the agency
• The agency provides worker’s compensation and payroll taxes
• The agency may choose to end the service because the agency-not the caregiver-is regarded as the provider of the service
• Caregivers are generally bonded and liability-insured because they are employees of the agency
• In-Home Care Agency restrictions on how care is delivered is determined by the State of Oregon and sometimes company franchise rules
• Once the caregiver is placed with the consumer, the agency continues to oversee the situation and assumes responsibility for the actions of the caregiver
• In-Home Care Agencies have been licensed by the State of Oregon since 2001. There are about 140 in the Portland-Metro area.

What are Non-Profit Listing Services/Classifieds?
Counties and hospital affiliates offer free lists to consumers, where the caregivers self-advertise their services, with little or no active brokering component; it is a static list in which consumers contact caregivers directly. Caregivers may be screened and/or required to take classes to be on the list. Internet-based searches may also be done; www.Care.Com are two ways in which consumers can seek private caregivers. Features:

• Like a for-profit registry, the consumer or representative selects and hires the caregivers and may be responsible for payroll taxes
• Caregivers and consumers control all terms directly-duties, compensation, etc.
• There is generally no referral fee charged, or a minimal one-time fee to acquire the list or to be listed
• “Anyone can join” means that aside from basic criminal background and reference checks, there is minimal refinement in the requirements to be listed
• Least expensive option for consumer but also carries the greatest responsibility

Article provided by:
Caregiver Connection, Inc.
Email  Website  Phone: 503 246-4672  Fax 503 246-4913

Be Cautious As You Invest

Does it sound too good to be true? It’s essential to ask yourself this question when a “can’t fail”  investment opportunity comes your way.  In today’s sluggish economy it is tempting to grab at an offer to make up the losses in your retirement nest egg. Unfortunately there are people looking to make a quick buck and will offer you an opportunity that can take a bite out your savings. Each year Oregonians lose millions of dollars to investment, or securities, fraud– by con artists using high-pressure tactics and promising “get-rich-quick” schemes.

As a potential investor, you may be solicited through telephone calls, mailings, emails and references from friends or family. If a enticing offer comes your way,  be cautious and get the necessary information to make an informed decision. Your first step? Check out the person offering the investment by contacting the Oregon Department of Consumer and Business Services. Its Division of Finance and Corporate Securities – the state’s securities, or investments – regulator – can tell you if the firm or salesperson is licensed to sell investments in Oregon and if the investment is registered for sale in Oregon.
Whether the opportunity comes from a broker, investment adviser or insurance agent, the Division can provide important licensing information including possible disciplinary  action.

In addition, check a person’s professional credentials. In Oregon, those who sell financial and insurance products are prohibited from marketing themselves by claiming they are a “specialist,” “adviser,” or similar title when they have no substantive credentials based on legitimate professional training. Senior citizens are vulnerable to this type of deceptive marketing as many are looking for ways to invest and may targeted by those claiming to have specialized expertise.

You should also be wary of the following pitches:

• The promise of a rate of return that is better than what similar investments are paying.
• A guarantee that the investment won’t fail.
• Insistence that the opportunity to invest exists today only – tomorrow will be too late.
• Pressure to write a check immediately or for a bank account number “to make it easier.”

Even with the current economic downturn, there are still many opportunities that hold great promise of financial return. The key is look at each one objectively, ask a lot of questions and check and verify the salesperson and the investment.

Article Provided by:
The Oregon Division of Finance and Corporate Securities
1-866-814-9710
www.dfcs.oregon.gov or www.protectyourmoneyoregon.org

A Guide to State Regulations & Terminology

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“I Still Do!!” – Every Marriage Matters

Reverse Mortgages Provide Additional Income, Security for Seniors

Senior Housing Options

Recently, there has been a proliferation of senior housing communities. Families have many choices when the need for a senior housing facility arises. With so many new options in senior housing, it is important to seek professional assistance in order to make the right choice. One resource is a senior housing referral service. Family Advisors are available to answer questions about senior housing options.

Independent Living Communities

Independent communities cater to seniors who are very independent with few medical problems. Residents live in fully equipped private apartments. A variety of apartment sizes are available from studios to large two bedrooms. Fine dining services are offered with custom-designed meal packages. Often, residents can choose to pay for a specified number of meals per day. Frequently, there are numerous social outings and events to choose from for entertainment.

Also Known As: Retirement Communities; Congregate Care; Retirement Living
Payment Sources: Mostly private pay; Some government funded through Section 202
Price Range: $1000-$2500 per month

Assisted Living

Assisted Living communities are designed for seniors who are no longer able to live on their own safely but do not require the high level of care provided in a nursing home. Assistance with medications, activities of daily living, meals and housekeeping are routinely provided. Three meals per day are provided in a central dining room. Residents live in private apartments which frequently have a limited kitchen area. Staff are available 24 hours per day for additional safety. Most assisted living communities provide licensed nursing services. The hours vary greatly, so be sure to ask when you visit. Social activities and scheduled transportation are also available in most communities. A special unit for Alzheimer’s residents is available in some, but not all communities.

Also Known As: Assisted Care Community
Payment Sources: Mostly private pay; Some take Medicaid
Price Range: $1800 to $3500 per month depending on the size of apartment and level of assistance required; Alzheimer’s care ranges from $2800 to $3800 for a shared suite

Nursing Homes

Nursing homes provide around-the-clock skilled nursing care for the frail elderly who require a high level of medical care and assistance. Twenty-four hour skilled nursing services are available from licensed nurses. Many nursing homes now provide short-term rehabilitative stays for those recovering from an injury, illness or surgery. Long-term care residents generally have high
care needs and complex medical conditions that require routine skilled nursing services. Residents typically share a room and are served meals in a central dining area unless they are too ill to participate. Activities are also available. Some facilities have a separate unit for Alzheimer’s residents.

Also Known As: Convalescent Care; Nursing Center; Long Term Care Facility
Payment Sources: Private Pay; Medicare; Medicaid
Price Range:$4000 to $8000 per month

Alzheimer’s Care

Housing options for seniors with dementia or Alzheimer’s are numerous. With the memory impaired, it is important to have 24-hour support and structured activities to ensure their safety and quality of life. Many families try to care for their loved ones at home, which can be extremely difficult given the skill that is required to care for a person with memory problems.

If you need to consider a community, understand that Alzheimer’s care is delivered in the assisted living setting, as well as in nursing homes and occasionally in personal care homes. Generally, the residents live in semi-private apartments and have structured activities delivered by trained staff members. Most of these living environments have secured or locked areas to ensure no one wanders off. Many times, within the secured areas, residents have access to outdoor walking paths or gardens.
Also Known As: Memory Care; Dementia Care
Payment Sources: Private Pay; Medicaid
Price Range: $3000 to $6000 per month

Residential Care Homes

Residential care homes are private homes that typically serve residents who live together and receive care from live-in caretakers. These homes offer assisted care services for seniors who want a more private, home-like community. Assistance with activities of daily living such
as bathing and dressing are typically provided. Amenities and nursing services vary greatly between homes. Ask about their services when you tour.

Also Known As: Board and Care Homes; Group Homes; Adult Family Homes
Payment Sources: Private Pay; Medicaid (in some instances)
Price Range: $1500 to $3000 per month depending on the services and level of care provided

Respite Care

Respite care provides a temporary break for caregivers by allowing a resident to have a short-term stay in a community that can meet their needs. Many assisted living communities and nursing homes have a respite care program. Residents typically stay from a week to a month, depending on their situation. They receive all of the services of the community. Respite stays may also serve as a “get acquainted” period for the senior. Many residents find that they enjoy their stay and decide to move in soon after the short-term visit. Respite programs are available for assisted living and Alzheimer’s residents.

Also Known As: Short-Term Stay Programs
Payment Sources: Private Pay; Medicaid (in some instances)
Price Range:$75 – $150 per day

Home Care

Home care allows older people to remain in their own homes while receiving the assistance they need to help them remain independent. Typically, home care involves providing assistance with Activities of Daily Living (ADLs) such as bathing, dressing and meal preparation or Instrumental Activities of Daily Living (IADLs) such as transportation, paying bills, making
appointments and simply being there to provide companionship and emotional support. Home care services range from once a week to 24 hours a day depending on the needs of the client.

Also Known As: Home Health Care; In-Home Personal Care
Payment Sources: Private Pay; Medicare/Medicaid via certified home health agencies
Price Range: Typically an hourly fee

 

Article Provided by:
Linda Temple, CSA,
A Place for Mom, Eldercare Advisor
Local & Toll Free 1-866-333-2268

The Oregon Long Term Care Partnership Program
A Successful Alliance Between Business and Government

Stay Healthy at 50

Get the Screenings You Need

Screenings are tests that look for diseases before you have symptoms. You can get some screenings, such as blood pressure readings, in your doctor’s office. Others, such as mammograms, need special equipment, so you may need to go to a different office. After a screening test, it’s important to ask when you will see the results and who you should talk to about them.

For Women:

• Breast Cancer – Talk with your healthcare team about whether you need a mammogram.
• Cervical Cancer -Have a Pap smear every 1 to 3 years until you are age 65 if you have been sexually active. If you are older than 65 and recent Pap smears were normal, you do not need a Pap smear. If you have had a total hysterectomy for a reason other than cancer, you do not need a Pap smear.
• Osteoporosis (Bone Thinning) – Have a screening test at age 65 to make sure your bones are strong. If you are younger than 65 and at high risk for bone fractures, you should also be screened. Talk with your health care team about your risk for bone fractures.

For Men:

• Abdominal Aortic Aneurysm – If you are between the ages of 65 and 75 and have ever been a smoker (smoked 100 or more cigarettes in your lifetime), talk to your health care team about being screened for abdominal aortic aneurysm (AAA). AAA is a bulging in your abdominal aorta, the largest artery in your body. An AAA may burst, which can cause dangerous bleeding and death.
• An ultrasound – a painless procedure in which you lie on a table while a technician slides a wand-like medical device over your abdomen, will show whether an aneurysm is present.

For Both Men and Women:

• Colorectal Cancer – Have a screening test for colorectal cancer. Several different tests—for example, a stool blood test and colonoscopy—can detect this cancer. Your health care team can help you decide which is best for you.
• Depression – Your emotional health is as important as your physical health. Talk to your health care team about being screened for depression especially if during the last 2 weeks: You have felt down, sad, or hopeless or You have felt little interest or pleasure in doing things.
• Diabetes – Get screened for diabetes if your blood pressure is higher than 135/80 or if you take medication for high blood pressure. Diabetes (high blood sugar) can cause problems with your heart, brain, eyes, feet, kidneys, nerves, and other body parts.
• High Blood Pressure – Have your blood pressure checked at least every 2 years. High blood pressure is 140/90 or higher. High blood pressure can cause strokes, heart attacks, kidney and eye problems, and heart failure.
• High Cholesterol – High cholesterol increases your chance of heart disease, stroke, and poor circulation. Have your cholesterol checked regularly if:
  • You use tobacco.
  • You are obese.
  • You have a personal history of heart disease or blocked arteries.
  • A male relative in your family had a heart attack before age 50 or a female relative, before age 60.
• Sexually Transmitted Diseases – Talk to your health care team about being tested for sexually transmitted diseases.
• Overweight and Obesity – The best way to learn if you are overweight or obese is to find your body mass index (BMI). You can find your BMI by entering your height and weight into a BMI calculator, such as the one available at: www.nhlbisupport. com/bmi. A BMI between 18.5 and 25 indicates a normal weight. Persons with a BMI of 30 or higher may be obese. If you are obese, talk to your health care team about seeking intensive counseling and getting help with changing your behaviors to lose weight. Overweight and obesity can lead to diabetes and cardiovascular disease.

Article provided by the Staff of Retirement Connection
taken from: Agency for Healthcare Research & Quality “Stay Healthy at 50+” 

Building a Stronger Community Through Intergenerational Programs

The Benefits of Intergenerational Programming 

Over the past twenty years there has been a growing amount of literature and research which identifies a trend in which younger people and older senior adults are becoming more and more separated in terms of living arrangements and social, recreational outlets. As of 2009 there were almost 40 million American’s over the age of 65. With seniors being forced to work longer into their “twilight years” and younger children being forced into Day Care and “latch key” situations, due to working parents and divided homes, has further served to isolate our nations elders from other age groups. Likewise children who are in need of building relationships and receiving guidance from older adults find less and less opportunity to experience these relationships.

The National Council on Aging defines “intergenerational programs” as “activities or programs that increase cooperation, interaction or exchange between any two generations. They involve the sharing of skills, knowledge, or experience between old and young.” Intergenerational programs are designed to create meaningful relationships and experiences with seniors and young people, with the purpose of building community and developing relationships that last a lifetime.

Shared study is developmentally appropriate for all ages. Tasks like cutting and pasting builds fine motor skills for preschoolers and maintains fine motor skills for residents. In a recent project of Collage Creation, residents assisted 6-10 year olds in building collages that represent their interests. While cutting and pasting, older residents are able to share stories from their past, represented in the pictures. These shared stories are important for young children. Children learn to articulate their thoughts, listen and share memories of their own, as they cut, paste and search for pictures. This type of activity is excellent for memory stimulation in older adults. It doesn’t just connect generations but it’s “down-right fun!” as, Ellie, one of our residents explains.

The development of intergenerational opportunities that mix diverse age groups is a step to re-build strong communities as well as respect and love for young and old. Furthermore, intergenerational programs have been found to diminish ageist stereotypes, strengthen communities, and lead to improved services

Article provided by
Kerrie Huber, Director
The Heights at Columbia Knoll

Life Long Benefits of Lifelong Learning

Some of the most profound discoveries in the study of the human brain and aging have been made in the past decade. It‘s widely accepted that children’s formative development is best nurtured in a enriched environment, full of verbal, visual and physical stimuli. The more varied the experience and stimuli, the greater the child’s potential for intellectual and emotional development. But how many people recognize that the need for an enriched environment does not diminish in later life?

Recent research in brain health and adult development has revealed two groundbreaking discoveries. The first concerns neuroplasticity, the brain’s ability to generate new neural pathways in reaction to physical activities and new experiences. Research has shown that the adult brain has the potential to maintain this ability throughout the lifespan, if it is regularly presented with novel and challenging experiences. The second discovery is that social connections are vitally important to late-life cognitive, psychological, and physical health.

One of the challenges to creating a successful retirement is finding ways to enrich our personal environment through novel experiences and meaningful social interaction. While there are many solitary pursuits that can provide intellectual stimulation, many adults find that participation in lifelong learning programs offers both mental stimulation and social interaction.

Lifelong learning programs provide access to an on-going array of new ideas and experiences, in the classroom, and beyond.  Participation in these programs allow adults to develop the personal interests that are often set aside while raising families, and focusing on full or part time work.

Participants can share their knowledge and experience by leading informal courses, or by taking leadership roles within their learning community. Lifelong learning programs acknowledge that participants have valuable experiences that can and should be shared with others. The programs also provide avenues for social interaction with an expansive community of peers. Many find that new friendships are forged as they share their opinions in class discussions, or work side by side on projects.

Local opportunities for lifelong learning abound in both public and private settings, providing a variety of stimulating learning experiences for increasingly diverse groups of older adult learners. While these programs and organizations may differ in focus, all promote a more positive approach to the transitions and experiences of life after fifty. Why not give one a try?

Article provided by:
Osher Lifelong Learning Institute
University of Oregon
541-346-0698