Once the difficult, emotional decision to place an elderly or infirm family member into nursing care has been made, there comes the decision of choosing the best, safest, most reputable, and top-rated facility possible.  In order to make an informed decision about nursing home care, many questions need to be asked of the facility, and the employees of the facility under consideration.

Some basic screening questions to ask are:

1. Is the facility medicare and medicaid certified?
2. Does the facility provide the level of care your loved one needs?
3. What specialized units for rehabilitation, occupational rehabilitation, dementia and Alzheimer’s care does the facility offer?
4. What specialized doctors, nutritionists and rehabilitation specialists are on staff, and what are their credentials?

Compliance and legal questions to consider are:

1. Is a copy of the most recent state inspection available for your examination?
2. What is the process by which a patient, or family of patient can file a grievance?
3. Is legal mediation service available?
4. What licenses and affiliations does the care center have?  Do they go above and beyond with the credentialing of their site and their staff?
5. What systems are in place to guarantee the safe, ethical and compassionate treatment of the residents?  Is there a employee screening process for potential new hires, newly hired employees, and regular supervision?
6. What is the employee evaluation and performance process?  Is it done “in house” or done by an outside, independent supervisor, and how many times per year?
7. Is there a legal team on site?

One of the things that Alzheimer’s caregivers learn is that the sooner that Alzheimer’s is diagnosed the better the potential outcome.  Here are 10 characteristics and behaviors of Early Stage Alzheimer’s as featured in Science Daily and from The Mayo Clinic.

Symptoms Mild Dementia/Early Stage Alzheimer’s disease

• Diminished short-term memory–ability to remember things that happened years ago, but not what happened yesterday
• Misplacing belongings in odd places; losing valuable belongings, like wallet or purse
• Difficulty finding the right word: “Tip of the tongue” syndrome
• Personality seems different, “not their usual self”, and shows uncharacteristic behaviors
• Lapses in judgment and problem solving ability
• Difficulty with mental arithmetic and handling money
• Disorientation in unfamiliar places or situations; also disorientation in familiar surroundings
• May become apathetic or withdrawn, avoiding social situations, avoiding straying too far from a comfortable environment
• More difficulty with routine tasks at work or at home, or may take longer to complete mundane, daily tasks
• Irritation or anger in response to increasing memory lapses

Specific Examples

• Asks the same question repeatedly within the same conversation
• Puts car keys away in refrigerator
• Drastic and sudden mood swings, irrational fear, anger, and paranoia
• Asks repeatedly about people from the past, or deceased family members as if they are present.
• Unable to recall word for “car” and then says in frustration, “The thing you drive to work in.”
• A normally shy person becomes uncharacteristically outgoing or talkative at a family gathering
• Agrees to buy services or products he/she doesn’t need from telephone sales person
• Finds it difficult to balance checkbook or figure out correct amount of money to pay for an item while shopping
• Forgets to eat, skips meals, or eats the same food every meal

Source: John Hopkins, Memory, Health Alert; http://www.alzheimersreadingroom.com/2010/05/ten-symptoms-of-early-stage-alzheimers.html

Often, when an elderly person begins to act out some of these behaviors, or behave differently, we chalk it up to “Oh, they’re just getting older”.  But, many of these signs could point to a more serious issue of either dementia or Alzheimer’s.  It is important to notice these behaviors and not diminish the message they’re sending you.  At this point, it would be worthwhile to see a specialist and have your loved one tested for memory loss.  Alzheimer’s is a crafty and degenerative disease that progresses over time.  Early detection could mean early treatment, and while there is no cure for Alzheimer’s disease, many Alzheimer’s drugs have shown promising results of staving off the progression of this debilitating disease when used in the early stages, with the help of early diagnosis.

Often, family members are the first caregivers for the elderly and infirm.  What are some tips for your family to reduce the stress of being a caregiver, to give you a respite from care giving, and still feel secure that your family member is receiving the same compassionate, dependable and loving care they need?

• Emotional support is a powerful stress reliever.  It can come from a supportive friend, family member, or professional health care provider.  It can also come from seeking out advice, help, feedback and support from other families who are in a similar situation.  This support is particularly effective when you can find a venue to share your burdens and fears with others who are either in, or have been in, your situation.
• Many may not share their burdens for fear that it is a sign of weakness.  ”Some avoid going to psychiatrists and psychologists to obtain emotional support because of the possible stigma associated with the need to depend on such services. Others with debilitating diseases like AIDS and cancer who are ashamed of or don’t want others to know of their condition may also avoid obtaining emotional support.” (American Institute of Stress http://www.stress.org/Emotional_support.htm).
• Having access to a pet or a companion animal, being surrounded by loved ones, children, and also having an in-home caregiver to provide a respite for the family caregiver are viable options to consider.
• Don’t feel guilty about taking care of yourself.  When you are caring for a loved one, you will be best able to give them your full support, attention and best care if you have also cared for yourself.  It’s the “airline safety adage” of “Put your own oxygen mask on before you put the oxygen mask on someone else.”  Regular diet, 8 hours of sleep, exercise, and hobbies–especially ones that invite you to be creative and put stress aside for awhile are the best.

Hospice Care is palliative, holistic end-of-life care.  Elder Care is different, and encompasses care for either short-term or long-term patients.  When is the best time to choose Elder Care and Hospice Care?  The decision is emotional and sensitive.  Here are some facts to consider:

Choosing Elder Care:

• First, talk to your elderly family member.  Even though they may be sick, they deserve to have a voice in whether or not they are ready to commit to this lifestyle change.  Include them in the decision process, and find out what criteria they require in an Elder Care Provider.
• Evaluate the needs.  An elderly person with few health concerns and some independence may be fine with a nurse coming to check on them a few times a week, or they may benefit from relocating to an assisted living, senior community.  A person with serious health problems, whether short term or long term, may need the 24-hour care of a nursing home or an in-home elder care specialist.

Choosing Hospice Care:

• When the goal of treatment moves from curing the illness to provide comfort for end of life, hospice care is a compassionate, honorable, and loving option.
• The best time to learn about hospice is before you need it. This time may come well before a physician indicates that the patient’s life expectancy is six months or less. By contacting hospice early in the diagnosis, the patient and family reserve time to understand their options and choose the path that will have the most positive impact on quality of life.

When a loved one is diagnosed with a terminal illness, it is important to consider whether elder care or hospice care is the best option.  Contacting a hospice, and having them as a retainer is a good idea.  If your family member’s health begins to improve through treatment, elder care can provide them the extra care, supervision and regular nursing they require as they recuperate.

• Aqua-aerobics.  Water’s natural resistance, buoyancy and cooling effects make it a perfect exercise arena for seniors.  Several classes in aqua-aerobics are offered at local YMCA, YWCA and private health clubs.    Water exercises offer a reduction in joint impact.  The stiffness and inflammation associated with osteoporosis and arthritis is less of an issue.  Health ailments such as diabetes, arthritis, menopause, cardiovascular problems, back problems and osteoporosis can benefit from water aerobics, says the Aquatic Exercise Association.  Read more: http://www.livestrong.com/article/104715-water-aerobics-exercises-seniors/#ixzz1rJ7XVqkR
  
• Tai Chi.  Pronounced “TIE-Chee”, this ancient art of self-defense is used today as a low-impact exercise and meditation to gradually increase heart rate, balance, reduce stress, and increase focus and awareness through a simple series of standing exercises and breath-work.  Movements are done in a constant and flowing pattern, and when practiced can have numerous benefits for all ages.  It can be done anywhere, and requires no equipment, other than a qualified Tai Chi instructor.  Many senior centers, nursing homes, senior day centers, and health clubs offer this practice.  It’s been practiced for thousands of years by Chinese, and in some larger cities, you can see large numbers of seniors gathering to practice Tai Chi every day.
• Dancing.  Like Tai Chi, dancing offers many benefits besides better energy, cardiovascular health and increased serotonin levels which stave off depression and make us happier overall.  Perhaps you have heard of the New England Journal of Medicine report on the effects of recreational activities on mental acuity in aging?  If not, here are the findings in a nutshell:  The 21-year study of senior citizens, 75 and older, was led by the Albert Einstein College of Medicine in New York City, funded by the National Institute on Aging, and published in the New England Journal of Medicine.  Their method for objectively measuring mental acuity in aging was to monitor rates of dementia, including Alzheimer’s disease.  Here were the results:  Of the activities that seniors engaged in, one stood out among the rest as offering a reduced risk of dementia, as well as cardiovascular and mood enhancing benefits–frequent dancing.
  Reading – 35% reduced risk of dementiaBicycling and swimming – 0%Doing crossword puzzles at least four days a week – 47%Playing golf – 0%Dancing frequently – 76%. 
  That was the greatest risk reduction of any activity studied, cognitive or physical.Here is a link to the New England Journal of Medicine Study:  http://www.nejm.org/doi/full/10.1056/NEJMoa022252Plus:  Here is another interesting article about the benefits of social dancing for seniors.
  
  http://socialdance.stanford.edu/syllabi/smarter.htm
  
• Yoga.  While yoga is seen by many as a vigorous, sweaty activity that is often done by lithe 30-somethings in a heated room, it doesn’t have to be that way.  Yoga practice can be tailored specifically to the needs and health of seniors too.  Gentle yoga practice can offer a sense of physical and mental balance, stave off depression, hypertension, increase cardiovascular health, flexibility, and reduce the muscle atrophy, joint pain and lack of mobility often associated with getting older.  Each yoga pose can be modified to help and not hurt our bodies, while gently and gradually increasing our range of movement.  Yoga also causes the heart rate to go up gradually, which adds to our overall heart health and increased blood flow over time.  Like Tai Chi and dancing, the benefits of yoga have been reported for centuries.  Many seniors have found happiness, increased energy and health by practicing yoga.
• Power Walking.  Thousands of doctors recommend it. Hundreds of studies extol its benefits. It’s simple, enjoyable, inexpensive, and you can do it virtually anywhere as long as you invest in a good pair of walking shoes. When done right, walking can blast away fat as fast as jogging–maybe faster.  This is because we burn the same amount of calories over the amount of sustained time we spend walking, and not the speed or distance.  Especially for seniors, Power Walking  is easier on the joints, because by walking quickly, you will hit the ground with half of the impact force of jogging. As a result, you’re less likely to have your fitness goals sidelined by soreness or injury.
  Read more: http://www.prevention.com/fitness/fitness-tips/power-walking-blast-fat#ixzz1s2v3qnFY

Did you know that for many seniors, malnutrition is a serious healthcare problem and is becoming more common?  For some seniors, a loss of appetite may be due to certain medications, or some illnesses like dementia and Alzheimer’s.  Fixed incomes also contribute to a lack of healthy foods, and also limited mobility—not being able to prepare food as easily as in the past.  The good news is that there are affordable and easy guidelines to keep seniors healthy, with more energy, and with more food choices.

What are the minimum daily calories needed for seniors?

A woman over 50 who is:

• Not physically active needs about 1600 calories a day
• Somewhat physically active needs about 1800 calories a day
• Very active needs about 2000 calories a day

A man over 50 who is:

• Not physically active needs about 2000 calories a day
• Somewhat physically active needs about 2200-2400 calories a day
• Very active needs about 2400-2800 calories a day

Source: National Institute of Aging

Fruit – Focus on whole fruits rather than juices for more fiber and vitamins and aim for around 1 ½ to 2 servings each day. Consider berries and melons like blueberries and cantaloupe. Both are rich in antioxidants, and will help you break free from apple and banana boredom.

Veggies – Eat your colors.  Colorful veggies are anti-oxidant rich, and full of flavor.  There are many frozen vegetable choices now—easy to steam in the microwave for fast, low-effort preparation.  Choose dark leafy greens, such as kale, spinach, and broccoli as well as oranges and yellows, such as carrots, squash, and yams. Try for 2 to 2 ½ cups of veggies every day.

Calcium –Adequate calcium intake can prevent osteoporosis and bone fractures. Seniors need 1,200 mg of calcium a day through servings of milk, yogurt, or cheese. Non-dairy sources include tofu, broccoli, almonds, almond milk and kale.  There are plenty of other non-dairy alternatives these days—and they are delicious and affordable.  Almond milk, soy milk, coconut milk, and calcium supplements are options to consider.

Grains –Whole grains support heart and circulation health, lowering cholesterol levels, and maintaining healthy weight.  Choose whole grains over processed white flour for more nutrients and a higher fiber count. **A tip:  Look for pasta, breads, and cereals that list “whole” in the ingredient list. Seniors need 6-7 ounces of grains each day (one ounce is about 1 slice of bread).

Protein – Seniors need about .5 grams per pound of bodyweight. Simply divide your bodyweight in half to know how many grams you need. A 130-pound woman will need around 65 grams of protein a day. A serving of tuna, for example, has about 40 grams of protein. So, when you think about it, that’s not a lot of protein, and should be easy to do.  Sources of protein should include fish and chicken over large quantities of red meat and pork, as well as beans, tofu, yogurt, almond milk, soy milk, eggs, lowfat cheese and some dense vegetables.

Source: National Institute of Aging

Before making any decisions about long-term care, get as much information as you can about the different kinds of care providers and what to ask them about their services. 

1.  What are my options for long-term care providers?

Your options for care depend on your medical needs.  Will your care be acute, temporary, or long-term?  Does it involve elder care, in home care, or relocation to a facility?  There are four common types of care services:

• In-home Care
• Assisted Living Facilities
• Nursing Home Care
• Adult Day Health Care Centers

2.  How can I pay for long-term care and also save on cost for care services?

• Did you know that few, if any long-term care services are covered by Medicare or Medicaid? While health care insurance and Medicare may pay if you need skilled care for a short time to recover from an illness or injury, with few exceptions, ongoing personal care needs of day-to-day living, and long-term rehab aren’t covered.
• Medicaid provides financial assistance for certain short-term health services and nursing home care for those with low incomes and limited resources.  A person must first use up their personal assets before they qualify for Medicaid assistance.
• Did you know–Most Americans are unaware of the total, sometimes hidden costs of long-term care.  Many falsely assume Medicare will pay for their care.  Medicare clearly states that they do not pay for any long-term care services.
• For many, financing healthcare means using other financial options—savings, IRAs and 401-k plans, and other sources of income, especially if the long-term care you need is non-medical/non-skilled care with daily tasks like transportation, heavy lifting, house work, other chores, dressing, bathing, and bathroom use.
• The experts at Personal Care, Inc. can assist you with specific financial questions and may be able to help you save money and also uncover options you were not aware existed.

3.  What licenses and certifications are maintained by the care provider?

• Each state issues licenses and regulates care providers, and many state regulations differ.  Visit the website for the Department of Health and Human Services in the state for which you’re inquiring.
• Make sure the provider maintains all required licenses, and inquire as to why they choose not to maintain licenses that are optional. You can find out what licenses are required or optional by contacting your Department of Health and Human Services.

4.  What staffing practices are in place?

Understand the provider’s staffing practices. Ask if the following practices are used in hiring for all care-giving positions:

• Verification of professional licensure or certification, if applicable
• Verification of prior employment and references
• Criminal background checks (Federal and State)
• Skills testing, and continued education

Discuss the experience of management staff and the turnover rate for care-giving positions. When possible, interview residents and other staff members and assess their satisfaction rates with the care site.

5.  How does the long-term care provider implement training and supervision?

• Proper staffing, training and supervision are important considerations. Be sure to ask about the training program for care-giving employees.
• Also ask how new employees learn the provider’s care protocols and at what point in their training are they allowed to work independently and without direct supervision.
• Clinical supervision of all care-giving activities should be routine and well documented.
• Ask about frequency of employee performance reviews. What kind of disciplinary practices are used for employees who do not meet the provider’s eligibility standards?

6.  How are daily care activities, health improvements and concerns monitored and addressed?

• A good long-term care provider will keep a daily log of activities and episodes. Maintaining a daily log to document the care provided is one way to make sure medications are taken properly and activities are included in your loved one’s daily care routine.
• These days, this process is often done with advanced medical software.  Ask the provider if they use state of the art monitoring and incident reporting software.
• The caregiver will usually log-in comments about mood, energy and appetite. In your conversations with care providers, you should ask if these logs are reviewed by clinical staff personnel and what the provider might do if you have a concern with what you read in the log.

7.  How will the care provider address your concerns or complaints?

• There should be provided a written complaint/resolution process available for your review, with options for mediation and detailed follow-through communication.
• Discuss the best avenues of communication and understand management’s availability for addressing immediate concerns.
• Learn how they will communicate with you and what they use for a response system. Many assisted living facilities and home health care organizations will be available through a call service for emergencies, and most nursing homes operate a nursing station that can be reached around the clock.

8. What about rates, increases and how to terminate services?

• Before signing an agreement, make sure it states clearly what type of notice will be given if rates for long-term care are going to change, and how much of an increase can be made at any given time. Learn their policies for terminating and cancelling service.
• For home care agencies there is generally a window of time when you can cancel a single visit and not be penalized for the cost. Often there is a required period of notice to terminate services entirely with both in-home and nursing home long term care.
• For assisted living facilities there is generally a termination policy if a resident chooses to move elsewhere.

While in home care is traditionally the oldest form of health care, it is also the newest.  Its popularity has been driven by the cost of assisted living and nursing facilities, plus a desire to have family close by when possible.  Advances in healthcare technology also make in home healthcare for seniors a more affordable, attractive option.  What are some of the advantages to in-home care?

• Keeping families together. When most of us are sick, we want to be at home.  Studies show that there is a psychological, emotional benefit from being surrounded by the comforts of home, familiar sights and faces.  Keeping families together, particularly during the healing process, is an important social value of in-home care.
• Promoting healing. There is abundant evidence to show that patients heal quicker and with lasting benefit at home.
• Keeping a sense of individuality and freedom.  Hospitals and nursing homes are structured, group-centered and regimented environments, and don’t often allow for as much individual independence and freedom.  In-home care focuses on the individual’s personal structure, personal goals, and return to a quality of life that seeks some independent living where possible.
• Preventing or postponing Institutional Care.  Unless monitored, around the clock care is required; few seniors choose nursing homes over in-home care.  Psychological and emotional stress, including depression, may result for many seniors when they are relocated into a nursing home before it becomes absolutely necessary.
• Tailored to the individual and the family.  In-home care is personalized, and builds on the strengths of the individual and their family support system.  Both the patient and the family are taught skills in getting better, and working as a team. The individual is taught how to get well, regain independence, and how to stay healthy.  Help is offered with cooking, cleaning, personal care and hygiene, and in learning how to use the individual’s own home environment as a tool for healthy recovery.
• It is both effective and efficient.  The AARP reports a high level of overall consumer satisfaction with in-home health care as compared to institutionalized care and long-term hospitalization.  Bringing health services home means the patient does not generate high-cost food and room expenses.  In-home healthcare technology and first response monitoring systems in case of emergencies have developed to the point where many services, once only available in a hospital, can now be offered at home.
• Being surrounded by a familiar home environment, by family and community, can be cost effective and can extend life.  The U.S. General Accounting Office study recently reported that seniors receiving in-home care report better quality of life, lower depression rates, higher rates of recovery, and live longer than those in institutional care.  The cost of in-home care is, in many cases, more affordable than nursing home care.  Generally, it is speculated that on a national average, in-home care costs only one-tenth as much as hospitalization and only one-fourth as much as nursing home placement to deal with comparable health problems.  Also, short term in-home care costs far less than lengthy hospital stays.

In home care extends beyond caring for the elderly and infirm.  Did you know that new or expecting parents can benefit from the assistance and education services offered by in-home care?  Here are just a few of the benefits.

1. When you are new to the area.  If you’re a couple with young children, or are expecting, and you’ve just relocated to a new area, chances are you’re away from your family, your friends, and the network of care they can provide you.  It may be difficult to find a steady, dependable friend or family member to help with running errands, making doctor appointments, and chipping in with child care for your new baby.  An in-home assistant, trained in pre and post natal care may be the answer.  Not only will they offer professional services for new parents around healthcare, mommy and baby care, but they can also provide sitting services, assist you in making appointments and running errands, and give new parents a break for the much coveted, well deserved “date night”.
2. Parenting is a tough, full-time job!  Personal Care, Inc. offers a variety of services and a catalog of well-trained, experienced and compassionate caregivers who can meet the specific needs of your new family.  In home assistance for new parents can offer peace of mind, and professional, insured, and reliable care for Mom and baby in the comfort of your home, allowing you to spend more time caring for your infant and less time stressing over juggling the numerous tasks associated with being a new parent.
3. When unexpected challenges arise.  Consider in-home assistance services on a temporary, part-time basis if sudden changes in your schedule and your availability, or your health make it difficult for you to devote all the attention you need to your family.  Perhaps a job, an injury, or family events have made it difficult for you to care for your newborn.  Temporary in-home assistance will free you to take care of short-term, acute obligations more quickly so you can return to your normal schedule sooner.  There is peace of mind in knowing that there is help available from a compassionate, consistent, and professional care-giver who is there to partner with your family.
4. It takes a village to raise a child.  Turning to a care-giver for assistance is nothing new.  It has been a practice in most cultures for centuries, and has become a growing field of expertise in the home-based healthcare field.  When family members, friends and daycare centers are not the best option for your family, turning to an in-home healthcare professional for assistance is certainly an option worth considering—for your family’s peace of mind, and for the continued health and well-being of your child.

Considering in-home elder care instead of residential elder care?  Although there are surely more, here are 10 helpful bullet points to assist you in the process.  Contact the In-Home Elder Care Experts at Personal Care, Inc. for more assistance, and answers to your questions and concerns.

1. Consider the home.  Will the elderly family member be staying in their own home, or moving in with your family?  If so–is their home equipped with safety attachments in the bathroom, kitchen and common areas?  Is the home wheelchair and hospital bed accessible/equipped?  Will your elderly family member be comfortable in this new arrangement?
2. Consider hours of contact.  What hours of the day will your family require services?  How will this impact your family’s current schedule and routine(s)?  In-Home Elder Care should be seamless, unobtrusive, and provide your family and/or your elderly family member some respite from having so much responsibility and burden throughout the day.
3. Consider cost.  Personal Care, Inc. can assist you in budgeting in-home services.  Things to consider are the level of care, frequency of care, and how much out of pocket expense your family, or elderly family member will be paying, not covered by medicare or insurance.
4. What are your elderly family member(s) needs?  Talk with them, and invite them to be part of the planning and funding process whenever possible.  Remember, this is a change for the better, but it’s still a change.   Addressing your family member’s concerns and desires for care will make finding the “right fit” much easier.
5. Consider the services offered.  In-home care services offer a wide array of choices for your lifestyle.  If you can find one person to meet all the needs of your loved one, instead of having to delegate responsibilities among two or more in-home care providers, your costs will be lower and the consistency of care will be greater.
6. Consider the availability of the provider.  When are they NOT available to be in your home, caring for your family member?  Do they offer rehabilitation to help your family member regain strength, independence and mobility?  If so, how often?
7. Consider the economy.  According to an article linked on the AARP (American Association for Retired Persons) website, “The good news is the cost of many home health care services have remained flat over the last few years, while the rise in the cost of facility-based care has been much steeper, according to the Genworth 2011 Cost of Care Survey. For example, the median annual rate for a private room in a nursing home rose from $60,225 in 2005 to $77,745 in 2011, a compound annual growth rate of 4.35 percent. The median hourly rate for a home health aide rose just 1.38 percent, from $17.50 to $19.  Hiring home health care services for a few hours a week over a short term is much less expensive than staying at a nursing home or assisted living facility, but the cost of constant at home care can add up. **The MetLife 2011 Market Survey of Long-Term Care Costs puts the national average hourly rate for home health aides at $21, while the rate for homemaker services, such as house cleaning or errand running, is $19 an hour.  If you need both kinds of assistance, that’s more than $200 a day to hire help in five-hour shifts. Compare that to the average daily rate of $239 for a private nursing home room, according to the MetLife survey, and the costs can level out and eventually surpass the cost for nursing home care.”  Read more: Planning For Home Health Care Services | Bankrate.com http://www.bankrate.com/finance/retirement/planning-home-health-care-services.aspx#ixzz1pOLc0rzN
8. Consider how in-home health care can minimize further health risks.  Even having a professional come into your home for a few hours, just a couple of times a week to assist with laundry, cleaning, errand-running and provide physical therapy to increase mobility can reduce the risk of accident and injury associated with a fall.
9. Consider advances in technology.  The market is growing for at-home medical equipment and technology that make it safer for seniors to age in place. For a personal emergency response system — such as the ones in those TV commercials — you might pay about $30 a month for the monitoring service, along with the initial cost of the equipment and installation.
   Julie Menack, a gerontologist and certified geriatric care manager in Oakland, Calif., who specializes in technology for aging in place, says motion-sensing devices can often detect signs of possible health problems for seniors:  ”If there’s any change in the pattern — for example, if they are constantly going back and opening a cabinet — it might indicate that the person has dementia,” Menack says. “Or if they are going to the bathroom more frequently at night, there might be a medical condition such as a urinary tract infection. A remote caregiver can easily intercede without having to move a person to a higher level of care.”
10. Ask your doctor, and ask your friends.  Geriatric physicians often have links to support groups in your area who will be willing to help with funding, provide contacts, and get you in contact with other families who are making in-home health care an affordable option.  Also, please contact Personal Care, Inc.  We are the Triad area’s number one source for in-home, affordable health care options, and will be happy to assist you!