Caring for a Person with Dementia?

Posted on

Feb 26, 2018

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Caring for a person with dementia often takes its toll on the caregiver's health. The stress of the situation often causes medical and/or psychological issues for the person. Although stress cannot completely be eliminated, there are steps to take to avoid being in distress.
One of the first steps is to have a medical professional who understands dementia, the progression, the impacts, and the medical treatments. This doctor may or may not be the person's primary care physician. It could be a gerontologist, neurologist, geriatric psychiatrist, or a physician who has a strong understanding of dementia.

Having someone who understands the financial pieces of elder care is also key to avoiding a crisis down the road. An elder law attorney is able to help put the necessary pieces in place to assure that decisions can be made and that financial assets are being used in a way that is permitted or even protected. Medicaid and Medicare laws are complex and often changing. In addition, many elder law attorneys are aware of programs available to financially assist seniors.

Many caregivers find joining a support group is beneficial. Groups are often facilitated by a professional. This person usually has a strong understanding of the disease and the resources available. In addition, you will have the opportunity to share your experience with others who have the same experience as you. Also, it provides a safe environment to share thoughts with others who will not judge and can understand. In addition, you will get advice and support from someone who may have already faced the stage you are in now. Additionally, it will allow you to help others who are dealing with something that you have already faced. It is important to understand however that not all support groups are the same. Based on the participants, some are more geared for adult children while others for spouses. Finding the right one will add to the benefit.

Many people have family members as an important piece of the support team. To avoid conflict and perhaps crisis, it is key to have open communication and assure that everyone is on the same page. Putting some of the pieces into place can help the caregiver prevent some crisis and provide a better overall quality of life for everyone.

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Editors Note: This article was contributed by Mary Underwoods, Vice President of Memory Care Services for Artis Senior Living of the West Shore.

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Pennsylvanias Personal Care Assistance (PCA) Program: A Guide to Paid Family Caregiving

Providing care for a loved one is a profound commitment, and in Pennsylvania, various programs exist to support family caregivers in this vital role. While Personal Care Assistance (PCA) broadly refers to services that help individuals with daily living activities, its important to understand that paid family caregiving in Pennsylvania primarily operates through specific Medicaid waivers. These initiatives aim to support the invaluable work of caregivers while allowing loved ones to remain in the comfort and familiarity of their own homes or the homes of family members.Understanding Personal Care Assistance (PCA) in PennsylvaniaIn Pennsylvania, Personal Care Assistance (PCA) refers to the services that help individuals with daily living activities and household tasks, enabling them to live independently. Its crucial to differentiate this from Personal Care Homes (PCH), which are residential facilities that provide housing, meals, supervision, and assistance, but typically do not offer third-party reimbursement for family caregivers providing care within them.Instead, paid family caregiving for PCA services in Pennsylvania primarily operates through various Medicaid waivers, also known as Home and Community-Based Services (HCBS) waivers. These waivers are designed to provide direct assistance with Activities of Daily Living (ADLs) and household services for older adults or individuals with disabilities who live in their own homes or the homes of loved ones. The services provided under these waivers are what constitute Personal Care Assistance in the context of paid family caregiving.Key Pennsylvania Medicaid Waivers for PCAPennsylvania offers several Medicaid waivers that facilitate paid family caregiving for Personal Care Assistance, each with specific eligibility criteria and rules regarding family members.1. Community HealthChoices (CHC) Waiver: Getting Paid to Care for Loved OnesThe Community HealthChoices (CHC) waiver is Pennsylvanias most common Medicaid managed care program that facilitates paid family caregiving for PCA. It is designed for individuals aged 21 or older who are eligible for both Medicaid and Medicare and require a nursing facility level of care. This program consolidates several former waivers into a single, comprehensive system and is administered by private healthcare insurance companies contracted by the state.Recipient Eligibility for CHC: To qualify for the CHC program, the individual needing care must meet several criteria: Age: The recipient must be 21 years of age or older. Dual Eligibility: They must be eligible for both Medicaid and Medicare. Functional Eligibility: A physician must certify that the individual has a condition requiring long-term services and supports, specifically an inability to perform essential Activities of Daily Living (ADLs) such as bathing, toileting, or transferring. A trained assessor will also conduct a functional eligibility determination to confirm the level of care needed. Financial Eligibility: The individual must meet specific income and/or asset requirements, determined by the local County Assistance Office (CAO). 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Staffing Requirements in Assisted Living

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Independent living residents receiving no services are excluded. # ResidentsStaff Hours/Week051686152121625253263529436453354655375566541666754577685498869553996++42 hours per week for each additional 20 residents 2. Staff Availability & Ratios24/7 supervision:At least one qualified staff member must be on-site anytime residents are present home.caringdata.com+5casetext.com+5quality.healthfinder.fl.gov+5.For facilities with 17+ residents, one staff member must be awake and present around the clock FirstAid/CPR coverage:At all times, someone on duty must hold a valid First-Aid and CPR certificate (nurse, EMT, or paramedic qualifies) .Responsible staff in absence:If the administrator or manager is absent longer than 48 hours, a written-designated staff member (21+) must oversee facility duties  3. Staff Qualification & TrainingAdministrator oversight:Every ALF must be supervised by a licensed administrator responsible for operations and staff management.Preservice & Core Training:New staff must complete at least 2 hours of orientation before resident interaction.Ongoing training related to job duties and care must meet FAC 59A36.011 requirements. Medication assistance:Staff helping with self-administration of medication require 6 additional training hours, followed by 2 hours annually. Background screening:All employees (including contracted staff) must undergo Level 2 background checks.  4. Documentation & OversightSchedules & recordkeeping:Facilities must maintain written 24hour staffing schedules and time sheets. 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