This blog is not about strangers lurking in an alley.  Nonetheless, nursing homes are routinely “invaded” in the wee hours and weekends, because they are subject to unannounced night and weekend visits by trained teams of Medicare inspectors.

These snoopy night stalkers show up and  “camp out” in the facility for days.  These teams have full authority to review and audit over 180 different items covering all major aspects of care in a skilled nursing facility.  They inspect the buildings, the medical records, the residents, the cleanliness, the staffing hours per resident, and much, much more.  These investigators are there to find deficiencies, note them, and  report them to the Center of Medicare and Medicaid Services (CMS).  The report is used to provide a rating which is available to the public at the Nursing Home Compare website. 

The website lists each nursing home and assigns a quality rating between 1 and 5 stars.  A 5-star nursing home is heavenly! Unfortunately, a 1-star nursing home is a probably a living hell.

CMS has created this rating system to help seniors and their loved ones see behind the scenes and beyond the nice décor to find a safe and nurturing care facility for a frail senior.
 
The most coveted score is a 5-star Medicare quality rating.  That score is received by only 10% of all skilled nursing home facilities.  There are very few facilities who receive such an award even when they are in the luxury market.  It is even more impressive when a facility which accepts Medicaid residents qualifies as a 5-star-rated Medicare facility.  Recently Tower Hill Healthcare of South Elgin, Illinois announced in their newsletter that they had received a 5-star award.  I was impressed!  Tower Hill is a 206-bed Medicaid-certified skilled care facility with a 31-bed Alzheimer’s wing.

In my next blog, you will be introduced to a 33-year-old orthodox Jewish synagogue cantor and  wedding singer, Jeremy Amster, whose leadership skills have earned the 5-star rating.

Her voice, once upbeat and positive, was filled with anguish and despair as she said, “I just had another nerve block treatment to try to stop this never-ending, excruciating pain—and I’m still in torment.  In the blink of an eye, this disease totally changed my life.  I feel like life as I knew it is over.  I just want the old me back!”  One of my friends is suffering from long term nerve pain, which is one of the most common complications caused by Shingles. 

Although Shingles can occur at any age, seniors and baby boomers are the primary groups seriously affected by it.  Very recently, I have encountered this disease among my friends.  Quite frankly, I’ve never really known anything about this disease.  Nonetheless, I’m now convinced everyone over the age 60 should rush to get a Shingles vaccine. 

Shingles is a little known and underestimated foe. It is not a “pretty” disease and you definitely want to avoid it.   

Almost every adult is a “shingles carrier.”  If you had Chicken Pox, then you are carrying the Shingles-producing virus.  It’s probably dormant right now, lurking near your nerve cells.  Over 90% of the North American population has had Chicken Pox, so you stand a fair chance of developing Shingles at some time during your aging process, or any time your immune system is compromised by sickness, stress, or medications. 

You don’t catch Shingles; rather, your long-dormant Herpes Zoster virus wakes up angry and attacks you without warning.  Painful, ugly skin rashes erupt on the face and/or other parts of the body.  Unfortunately, these itchy, burning, blistering rashes hang around for about a month on the average.  If you do develop such symptoms, run—don’t walk—to get treatment right away.  There are helpful medications  which  are designed to lessen the extent and severity of the disease. 

After researching the disease for this blog, I highly recommend the $150 vaccine, which can cut the risk of long term nerve damage by 67%.  Anyone over 60 has a 50% probability of getting hit by this stealthy enemy.  Why risk scarring, skin infection, loss of vision or hearing, facial paralysis, and long term nerve pain (known as Post Herpetic Neuralgia or PHN)?  The Center for Disease Control (CDC) has recommended that all adults over 60 get an injection of the Zostavax  vaccine.  Even though I am just 59, I have called my primary care physician to arrange to get this vaccine.   The vaccine is safe.  It has been proven effective in preventing horrible nerve damage for 2 out of every 3 older adults who receive it. 

I just spoke with my friend again.  She is still suffering.  She asked me to beg, not urge, you to call today to get the Shingles vaccine.

How do you find and retain a great caregiver for a loved one with Alzheimer’s Disease?

Many of our clients and client families struggle with disabilities and/or long-term diseases.  The majority are impacted by the progressive dementia caused by Alzheimer’s Disease.  Alzheimer’s often causes people to lose what my mother, Gloria, calls our “thin veneer of civilization.”

I spoke with Mike Rohan of All-Trust Home Care to seek answers as to how our AD clients can stop the problem of caregivers coming and going.  Mike’s firm provides professional caregivers in the home environment, as well as assisted living and nursing home situations.  He shared with me that his company used to have a constant problem in staffing for Alzheimer’s clients; caregivers would often quit or demand reassignment after only a week or two.  He said, “People with AD can present challenging behaviors, such as screaming, repetitive questions, paranoia, non-cooperation, and even violent aggression.  Very few caregivers have been trained in how to deal positively with these challenges.” 

Mike decided to seek out a solution that would serve both his employees and the All-Trust clients.  He signed up for a program offered through the Alzheimer’s Association called the “Best Friends Approach to Dementia.”  Mike has also attended the “Train the Trainer” classes for the best friends approach.  After completing the program, Mike began to teach his firm’s caregivers how to implement the Alzheimer’s care ideas included in the best friends approach.  The results have been nothing short of revolutionary.  It has worked out so well, that now All-Trust offers a training class every other Friday at their Westchester, Illinois office.  The classes are open to their employees, client family members, and when there is space, members of the community. 

Caregivers have responded very positively to the training.  And they now have the tools that need to communicate effectively with their clients, despite the barriers of the clients’ dementia-related behaviors.  The quality of life for both the caregivers and care receivers has been remarkably improved.  In fact, Mike smiled broadly when he stated, “Before we implemented the best friends approach training, it was difficult to retain staff.  But now I cannot think of anyone who has quit.”
 
For more information about the Best Friends Approach to Alzheimer’s Care, go to www.bestfriendsapproach.com/Models.html

For information about how your family or organization can benefit from the Alzheimer’s Association training, see their website.  In addition, I’m sure that Mike would be glad to share with you some of his insights and experiences as he has implemented the program at his firm in Westchester, Illinois.  Their contact information is:

Mike Rohan
All-Trust Home Care
10526 West Cermak Road - Suite 114
Westchester, IL 60153
Phone: 708-492-1286
E-mail: MikeR@AllTrustHomeCare.com

You can play a big part in delaying and/or preventing the symptoms of Alzheimer’s Disease!

At a recent Alzheimer’s Association event in Chicago, I was surprised to learn that we can make lifestyle choices that can push back against the effects of Alzheimer’s Disease. Dr. David Bennett of Rush Medical Center reported that based on yearly interviews and later autopsy of participants in the 2,400 person Religious Orders Studies, there are people who have the Alzheimer’s Disease cerebral plaques and tangles but do not experience AD dementia, and/or have a delayed rate of decline.

Read on to see how you can choose to model these people.
 
When the Rush investigative team examined the data, it was clear that the best lifestyle models are those individuals who remain active in the areas of physical fitness and use of their mental capabilities, and have a vibrant social life.  A vibrant social network is defined as having more than seven active and significant relationships (friends, family, and coworkers).

People who remain consistently physically active usually have better brain health.  Those who are committed to exercise experience fewer falls, better balance, less brain shrinkage, and a higher level of independence.  For those of you who do not like to sweat, there is still good news.  Physical exercise does not have to be strenuous or require a major time commitment.  However, substantial physical exercise does mean a commitment to the regularity of the activity.

If you combine regular physical activity such as walking with mental activity such as Sudoku, and have an active social interaction such as playing cards with your friends or being involved in volunteer activities, then there is a much higher probability for you to successfully push back against Alzheimer’s Disease.  This is good news, in that most of us want to have this type of a lifestyle—we all want to be fit, have wit, and stay “with it.”  Let’s all get off the couch and go for a walk… or maybe a little hula-hooping!