How am I Going to Afford Assisted Living or Home Care When I Need It?Working with many seniors and families over the years from many different backgrounds and socioeconomic situations, makes this a somewhat scary and serious topic for many.  Will I have enough money to afford care? I dont want to be a burden on my family. I planned to stay in my home till I die. Social Security and Medicare should cover my costs for care, right?  Lets talk about the costs, misconceptions, and options for paying for Assisted Living and Home Care. Knowing what to plan for and expect before you need it will provide peace of mind for not only you.Cost of Home Care and Assisted LivingLets start by talking about the big elephant in the room.  The need for a caregiver, Assisted Living, and Memory Care is expensive!  The average in Home Caregiver charges $25-$35/hr., which can up quickly. Once one needs 24/7 it can be upwards of $18,000/mo.+ for a private caregiver. This is where Senior Assisted Living and Memory Care Communities can provide 24/7 care needed in a safe environment at a more affordable rate, typically ranging from around $4,000-$9,000/mo. in the DFW area depending on the location, community, type of room and level of care needed. When one ages significantly or has a medical condition that warrants care, many find that they are not fully prepared for the care that may be necessary long-term. Medicare MisconceptionWe often hear the question: I have Medicare and a supplemental insurance. Doesnt that cover the care I need?  This is a common misconception.  While Medicare and supplemental insurance like AARP cover your medical needs in the hospital, rehab, and Home Health (Physical Therapy, Occupational Therapy, Speech Therapy), it does not cover Home Care/Caregiving Assistance which provides the individual assistance needed for Activities of Daily Living (ADL). ADLs include things like bathing, dressing, grooming, toileting, meal preparation, feeding, etc. Payment OptionsThere are several options available when looking at paying for Senior Living and caregiving expenses: How to Pay for Assisted Living: 10 Ways to Cover the Costs (seniorht.com)1.     Personal Savings  Savings and Investments put aside for retirement.2.     Social Security Income  Income and retirement $3.     Pension Plans & Retirement Benefits  Company pensions and retirement benefits are great resources to have.4.     Long-Term Care Insurance (LTC)  These plans are costly but are designed to cover the costs of Assisted Living and when ADL assistance is needed.  There are many different types of LTC plans. Make sure to look over carefully and read the fine print when choosing the right one for you. 5.     Veterans Benefits  If one qualifies for veterans benefits and meets the criteria for pension and/or aid and attendance can receive financial assistance.  You may be able to even receive care in a VA Medical Facility or VA Facility, but the challenge many faces is that they are already full due to overwhelming demand. There is often a waiting list to get in. 6.     Medicare  Covers 100% of the cost of care up to 20 days at a skilled nursing facility and approximately 80% of the cost up to 80 more days. This care must be after an overnight inpatient hospital stay and for recovery. Cost of room and board or personal care in assisted living is not covered, but it will pay for the medical costs, such as physical therapy, incurred while in assisted living. So, this is important to understand when looking at needs for ongoing care.7.     Medicaid  This would be for those that have spent down or do not have significant assets and income of no more than $2k/mo. This happens to more than you realize as the assets and saved retirement $ is gone and one has only Social Security. Note there is a shortage of Medicaid beds, and one must need skilled nursing in addition to low income to even qualify.8.     Supplemental Security Income - Anyone can apply for SSI and there is no charge. Check out if youre eligible through an online screening you can find at https://ssabest.benefits.gov/.  Different states have different rules, and the amount is nominal but can still be beneficial to check.9.     Reverse Mortgage  This option allows seniors to borrow against the equity in their home. This works great if one is able to/wants to stay in their home but can present a significant challenge when care needs become too great, and a transition is needed. 10.  Life Insurance Policy  This is a not so commonly known resource that could be available to help pay for Senior Living costs.  Note that these options would potentially reduce or eliminate any payout or benefit to beneficiaries once the policy holder dies.a.     Some policies have a living benefit options (accelerated death benefit), that allows the policyholder to take a portion of their death benefit early when they have a terminal illness or serious chronic illness. b.     Sell Your Life Insurance Policy Many policies can be sold to a life settlement company for a lump sum that can be used toward senior living and care expenses.No matter how you decide to plan and pay for your Golden Years in retirement, talking with a financial planner, estate/elder law attorney, and having those discussions with trusted family members is recommended. Knowing what to plan for and expect before you need it will provide peace of mind for not only you, but for your loved ones too.  Ruby Care Senior Living Advisors has helped countless families transition into Senior Living Communities throughout DFW with our personalized complementary services that aid families in finding a community that is a right fit based on budgetary, care, family, and geographic needs. We are passionate about helping seniors and their families navigate the overwhelming options and choices when it comes to senior living and ensure the best care, environment, resources, and quality of life for you and/or your loved one.  Britt Hemsell  Ruby Care Senior Living Advisor & Blog ContributorResources: Senior Home Transitions  https://seniorht.com/pay-assisted-living/Veterans Services OfficesCollin County - https://www.collincountytx.gov/veteransTarrant County - https://www.tarrantcounty.com/en/veteran-services.htmlDallas County - https://www.dallascounty.org/departments/veteran-services 

How to Identify and Prevent Edler Financial Abuse?Seniors are one of the most vulnerable populations targeted for financial abuse, frauds and scams.  One in ten Americans age 60+ has experienced elder abuse and the most frequent abuse being financially (Forbes.com).  How does this happen and what can you do to help protect yourself or your loved one from falling prey to this form of abuse?  Lets take a look at defining Elder Financial Abuse and the different things to look out for to help plan, discuss and prevent this type of abuse.  With the holidays in full swing, there are unfortunately there are those looking to take advantage of our unsuspecting, vulnerable, and good-hearted seniors.What is Elder Abuse? According to Forbes.com, Elder financial abuse is defined as someone illegally or improperly using an elders (aged 60 or older) money or belongings for their own personal use.The financial exploitation of elderly people comes at a great cost: It costs victims as much as $36.5 billion each year, according to the National Council on Aging. And it can be more difficult to detect than physical abuse and neglect because its often done by family members, trusted friends and caregivers.Seniors are targeted simply because they have money in the form of pensions, retirement savings, or home equity, which are appealing to those looking to take advantage. Elder financial abusers can be family members, or people with whom the older person has had a relationship.What do I need to Know?The Mandated Reported callas attention to 5 Financial Elder Abuse Statistics Everyone Should Know?1.     Growing Concern of Financial Elder AbuseFinancial abuse is a growing problem. The Consumer Financial Protection Bureau found that reports of elder financial abuse quadrupled from 2013 to 2017, rising to 63,500 reports of suspicious financial activity involving seniors in 2017. Furthermore, it is believed that these formal reports of suspicious activity likely represent only a small fraction of suspicious financial activity involving seniors in 2017. Furthermore, it is believed that these formal reports only represent a small fraction of actual senior financial exploitation.2.     The Financial Burden Can be HeftyConsumer Financial Protection Bureau found the average loss to an older adult who suffers financial exploitation is $34,200, and up to 7% reported up to $100,000.3.     When an Elder Knows Their Abuser, the Losses Can be GreaterWhen the senior knows the person exploiting them, they will often be taken for more money and losses, according to the Consumer Financial Protection Bureau. The senior often trusts the one looking after them to tell them the truth and not take advantage of them or their wealth. 4.     Family Members are the Most Likely to Exploit a SeniorThe National Center on Abuse reports that financial abuse occurs 54 % of the time by a family member. Often making this an even more difficult situation to get control of.5.     Abusers Often Have Their Own Financial DifficultiesThe National Center on Elder Abuse reports up to 30% of financial elder abusers often have financial troubles of their own. Where less than 1% of non-related or unknown perpetrators had financial issues.Know the Signs of Financial AbuseFinancial elder abuse is devastating. Fortunately, there are ways to recognize and report it to better help victims.       fraudulent signatures on bills      unusual or sudden changes in spending      sudden changes to financial documents such as a will, etc.How can I help prevent financial elder exploitation from happening? An AARP article points out 5 ways to help prevent this from happening:1.     Designate someone you trust as your financial power of attorney.2.     Appoint a trusted contact for accounts and investments.3.     Sign up for a service that tracks your bank accounts, investments, and credit cards.a.     Tech tools such as EverSafe and LifeLock can detect suspicious activity and protect against identity theft.b.     It is also a good idea to consolidate finances: accounts, limit # of bank cards, subscriptions. Less is often more in ways of being able to manage effectively.4.     Stay in touch with loved ones.5.     Get to now your loved ones caregivers. a.     Knowing them and being involved makes it less attractive for caregivers to take advantage.b.     When hiring in-home help, it is advisable to use a bonded agency that does background checks and takes action in case of theft. AARP also has a great video pointing out 3 ways to Protect Against Elder Financial Abuse: 3 Ways to Protect Against Elder Financial Abuse - Top Videos and News Stories for the 50+ | AARPWho do I go to if I believe my loved one is a victim of elder financial abuse?      Contact Adult Protective Services (APS) for your area      Contact your local District Attorney or Legal Aid office      The National Association of Adult Protective Services has a state-by-state directory.Ruby Care Senior Living Advisors wants all our seniors and their families to stay safe not only over the holidays, but throughout the year.  Wishing you and yours Happy Holidays and a Blessed New Year! Britt Hemsell  Ruby Care Senior Living Advisor & Blog Contributor Resources:Forbes.com:  Elder financial abuse is defined as someone illegally or improperly using an elders (aged 60 or older) money or belongings for their own personal use.Mandated Reporter: 5 Chttps://mandatedreporter.com/blog/5-crucial-senior-financial-abuse-statistics/rucial Senior Financial Abuse Statistics (mandatedreporter.com)National Center on Elder Abuse: https://ncea.acl.gov/What-We-Do/Research/Statistics-and-Data.aspxNational Adult Protective Services:  https://www.napsa-now.org/help-in-your-area AARP:  https://www.aarp.org/money/scams-fraud/info-2021/prevent-elder-financial-exploitation.html

As the world's population ages, the need for quality senior care has become more pressing. With a focus on facilitating the best home living assistance for seniors, Ruby Care Senior Living Advisors has taken a unique approach to advising and offering the best possible help. In an exclusive interview with Insights Care, Joyce emphasizes the importance of providing such assistance and how Ruby Care's knowledgeable advisors help clients navigate the right placement. This article delves into the innovative approach of Ruby Care Senior Living Advisors and its commitment to providing the best possible care for seniors.There is a famous quote saying, We rise by lifting others. Simply put, when you start helping others, your life starts to have meaning and purpose. Among many, the best step to human kindness is trailblazing the path of transforming million.With such a vision to facilitate the best home living assistance, Ruby Care Senior Living Advisors has a unique approach to advising and offering the best possible help. It facilitates home assistance to the senior population and provides the best care with its resourceful platform.Spearheading this change is its Founder, Joyce Logan, believes in providing the best help by networking with healthcare providers, such as home health, hospice, rehabilitation facilities, hospitals, physicians, and other senior service providers.Being curious to learn more about its efficient services, we at Insights Care crossed paths with Joyce, wherein she emphasized the need for such assistance and how the company with its knowledgeable advisors, helps its client navigate the right placement.Let us dive into the insightful interview.Please brief our audience about your company, its mission, and the key aspects of its stronghold within the senior care services niche.Ruby Care Senior Living Advisors help simplify the process of locating the best senior housing option for an aging loved one. We work with Independent Living, Assisted Living, Residential Care Homes, and Memory Care communities in the Dallas/Fort Worth Metroplex in finding the most appropriate housing solution.We save families or seniors countless hours and unneeded stress when they need to find a senior living community. Our service is complimentary as we are compensated by the communities once a loved one moves in. Our Mission: We listen, we guide, and we follow up to ensure that our clients find the senior living community that is perfect for them.Tell us more about the services that give you a distinct edge to stand out from the competition?Our advisors have over 80 combined years of experience in the healthcare and senior living industry. Many of our advisors are Certified Dementia Practitioner and Certified Senior Advisors as well as Care Navigators, thus, providing a vast array of knowledge across a variety of all disciplines. Our clients benefit from our collective knowledge in addition to placement advising.We are members of the National Placement Referral Alliance, an association that promotes best practices, code of ethics, and senior advocacy to the clients/families we serve.What is your opinion on the effects of the current pandemic on the healthcare sector, and what challenges did your company face during the initial phase of the pandemic?I feel the healthcare and senior housing industry came together as a group like no other industry. The communities and facilities were taking care of the most vulnerable, our aging population. They shared ideas and embraced technology while taking the safety of the residents to a new level.Our business was briefly impacted at the beginning of the pandemic because families were reluctant to move their loved ones to senior communities because they were on lockdown, which meant families were not able to visit.As families realized they were not able to care for their loved ones at home as well as a community, they trusted the communities to do what they do best, care for the aging population with their trained staff.The business was back to normal in September 2020, when the Governor directed the Health and Human Services Commission to open visitation options, allowing up to two trained essential family caregivers to visit their loved ones in their rooms to help ensure their physical, social, and emotional needs were being met.Our process on how we worked with families and communities was impacted longer, as we usually consult and tour with our clients face to face. Still, we had to rely on technology virtual tours and consultations until we were able to visit in person with the families again.With continuous technological development in the healthcare space, what is your prediction about the future of senior care services?As baby boomers age and seek senior living options, I expect the movement toward technology to increase. Smart Aging, which refers to Artificial Intelligence, will continue to expand. Telehealth will be more universal in communities as well as Virtual Reality (VR).As an established leader, what would be your advice to the budding entrepreneurs and enthusiasts aspiring to venture into the senior care services niche?You must make sure you have a passion for caring for the elderly. Do your research on the senior niche you are pursuing and know the ins and outs. Being an elderly advocate doesnt have a schedule and can be demanding, so be prepared to be available when the time is needed, it may take away from personal time, but its so rewarding.How do you envision scaling your companys operations and offerings in 2023?Ruby Care will continue educating our advisors and achieve certifications to continue to provide unsurpassed quality service to our clients. Staying current with the ever-changing health care environment and senior living trends will ensure that Ruby Care maintains its leading edge. We will continue building brand recognition and growing our team. As technology evolves, Ruby Care offers increased access to information and ease of communication.The Senior Living Industry is greatly expanding; its an industry on the rise. Ruby Care set itself apart by doing business in an altruistic way from the rest demonstrated by phenomenal growth since its inception in 2016.

Good Nutrition: Positive Impact on DementiaThere are over 6 million people living with dementia in the U.S. and 1 in 3 seniors die with Alzheimers or another form of dementia according to the Alzheimers Association.  While there are many different types of dementia there is currently no known cure.  Much research is taking place to indicate that good nutrition can have a positive impact on patients quality of life. Today we will talk about ways in which nutrition can play a key role in making a difference for patients with dementia.Definition of DementiaDementia is defined by the National Institute on Aging as the loss of cognitive functioning thinking, remembering, and reasoning to such an extent that it interferes with a persons daily life and activities.  Its important to understand what dementia is and the challenges those living with it face.  Dementia is considered a progressive condition, with Alzheimers disease being the most common form.  It affects memory, thinking, and behavior, making daily activities increasingly difficult. This can make it hard for one dealing with dementia to maintain a proper diet, which can result in weight loss, malnutrition, and other health issues.Nutrition in Dementia CareGood nutrition is important for everyone in maintaining good health, but especially plays a vital role in those living with dementia.  A balanced diet can provide a positive effect on a patients life, including cognitive function, physical health, and emotional well-being.  Cognitive Function - Good nutrition can slow the progression of dementia and boost cognitive function. Omgea-3 fatty acids, antioxidants, and vitamins are associated with improved brain health.  Foods such as fatty fish (salmon & mackerel), leafy greens, and berries, can help protect brain cells and enhance cognitive abilities.  Weight Management - Dementia patients often experience unintentional weight loss due to decreased appetite, forgetting to eat, or difficulty eating independently. A proper nutritious diet can help maintain a healthy weight. Preserving muscle mass and reducing risk of complications.    Hydration - Ensuring proper hydration is important for everyone but is critical for dementia patients as they lose the ability to feel thirsty.  Dehydration can increase confusion, agitation, and other behavioral symptoms.  Regular fluid intake and offering foods with high water content can help prevent dehydration.  Emotional Well-Being - Sharing meals with loved ones or friends fosters social engagement and a sense of connectedness promoting well-being.  Delicious and nutritious meals also provide a source of comfort and pleasure.9 Top Foods for Those with Dementia1.  Leafy Greens2.  Berries3.  Fish high in Omega-3 fatty acid4.  Beans5.  Whole Grains6.  Nuts7.  Sweet Potatoes8.  Seeds9.  Healthy Fats (Extra virgin olive oil, Coconut oil)Additional Tips Working in the senior industry and many with dementia and their families, here are some additional tips to think about to make mealtime a more positive experience:  Frequent and small meals  smaller and more frequent meals may be easier to manage and provide better nutrition overall as they may be easier to manage than large meals.  Maintain a routine  consistent mealtimes can help reduce anxiety and make mealtimes more enjoyable and comfortable.  Consult with a dietitian  a registered dietitian can address the personal dietary need of the patient and customize meal plans.  Larger grip utensils and handles on cups  This helps the individual be able to help facilitate independent eating as the disease progresses.While there is no cure for dementia, the impact of good nutrition is notable and continues to be studied.  Having a well-balanced diet can help improve cognitive function, supports overall good physical health, and enhances the emotional well-being of dementia patients.  By focusing on nutrient-rich foods, hydration, and a mealtime routine, caregivers can help make positive and significant impact in the lives of those living with dementia.  Proper nutrition along with a loving and supportive environment, can improve the quality of life for both the patient and the caregiver(s).  May we all continue to strive for compassion and understanding in caring for those with dementia while researchers continue to search for a cure for this disease that impacts the lives of so many we love.Author: Britt Hemsell | Ruby Care Senior Living Advisor & Blog Contributor

Where does one begin when considering or needing additional care for an elderly loved one or you are a senior and just tired of owning a home and managing the upkeep?  There are a variety of options available depending on what you are looking for and what type of care if any is needed.  There are so many choices and decisions to make, it can often be overwhelming. Today we are going to take a high-level view of each of the Senior Living Options available to give you an idea of some of the differences.  Senior Living options are broken down into 4 major categories: Independent, Assisted Living, Memory Care, and Residential Care Homes. Lets elaborate on the basic differences of each of the four Senior Living categories:Independent Living (IL) - These types of communities are often beautiful resort style with lots of activities and nice amenities. Typically has a variety of apartment style floor plans. A few communities have villas or cottages options. Most have full kitchens or a kitchenette, with many have a dining room with meals plans, housekeeping, transportation, optional laundry, salon, library, gym, pool, enrichment programs, art room, movie theatre, scheduled outings, happy hour, and concierge services available. Communities often have a visiting doctor and wellness checks for their residents.  Many residents still drive, and communities often accept pets. The category includes Active 55, Independent, Continuum of Care (Independent Buy In), and Senior Housing communities. Pricing varies greatly averaging anywhere from $1000/mo. - $6,000/mo. depending on location, size, and what type of services and amenities you are looking for. There truly is something for everyone.Assisted Living (AL) Communities in this category can still be resort style, but vary greatly in size, atmosphere, and offerings.  Most communities have studio style rooms with kitchenettes, but some have one and two bedrooms. Thought process for limited space and layout is for residents to come out to dine and engage with other residents.  All provide caregivers to aid with Activities of Daily Living (ADL), Medication Management, meals, housekeeping, laundry, salon, library, gym, outings, and engaging and fun activities. Many provide what they refer to as Levels of Care. Levels and capabilities vary between assisted living communities, as not all are equipped to handle high acuity care if needed, and Levels of Care add to the base monthly living cost. Community has nursing, and care giving staff as well as a visiting doctor.  Only some communities accept pets. This category includes Assisted Living, Continuum of Care (AL), and Residential Care Homes. Pricing average ranges from $3500/mo. - $8000/mo. depending on community, level of care, and additional services and amenities desired.Memory Care (MC) These are communities that specialize in care for those with cognitive deficiencies such as dementia, Alzheimers, Parkinsons, traumatic brain injuries, etc. Rooms are studio style and are free of kitchenettes for safety reasons. ADL care, meals, laundry, medication management, activities geared toward memory building and retention as well as general physical/mental wellbeing. Visiting doctor and staff is often trained in caring for those with memory care deficiencies.  Pricing typically is all inclusive versus Levels of Care, but some communities have different areas for those that are low acuity verses those that are at a higher acuity level. Not all Memory Care communities can accept a high acuity resident. All Memory Care communities are secured, as residents are often wandering or flight risks. Communities vary in size and atmosphere. This category includes Memory Care and Residential Care Homes.  Average pricing ranges from $4000/mo. - $10,000/mo. depending on community, diagnosis, evaluation of deficiency and acuity level. Residential Care Home (RCH) Care Homes are alternatives to larger Assisted Living and Memory Care communities that provide care in a home or home like setting. All provide caregivers to aid with Activities of Daily Living (ADL), medication management, meals, housekeeping, activities, but do not have the typical resort style amenities that the larger ALs have. The pros of and RCH is a smaller environment to navigate, caregiver to resident ratio typically 1-4, and meals and schedules can often be more customized and tailored for each resident, pricing is typically all-inclusive and very competitive to that of larger communities. Cons are that typically family has to arrange transportation to additional doctors other than PCP visiting physician, residents many times share a bathroom versus a private one, may not have as many socialization opportunities as in a larger community. More like a family home setting.  Residential Care Homes can be licensed, but many are unlicensed as an assisted living community.  In Texas, anyone with three or less residents (unrelated to them) does not have to be licensed. This generally creates a care ratio of three guests to one care provider.Pricing ranges on average from $3000/mo. - $8000/mo. depending on owner/operator and evaluation of care level needed. Even knowing which category, you may want or need, it can still be overwhelming to navigate the maze with over 900+ available options in Senior Living to choose from in the DFW area.  Letting a Senior Living Advisor, such as Ruby Care Senior Living Advisors, bring their expertise and experience to help narrow down your choices based on your personal preferences and needs. A Senior Living Advisor can be an advocate and resource in your corner, while walking you through the process.  Having a Ruby Care team member to ease the stress of making this life changing transition for you and all involved at no cost to you is priceless. Call Ruby Care today and let our team of Senior Living experts help you to find the place that is right for you or your loved one.  #seniorliving #seniorcare#independentliving #assistedliving #memorycare #residentialcarehomes #RUBYCARE #NPRATX #decisions #rubycarelife#rubycareseniorlivingsdvisorsBritt Hemsell Ruby Care Senior Living Advisor/Blog Contributor

Assisted Living is a term has sent mixed feelings for many seniors and family members. It represents a big change for many in their independence, health, environment, and lifestyle.  Assisted Living has changed quite a bit from what people used to envision in their minds of a nursing home, with seriously ill or severely debilitated individuals with limited activity and quality of life. These days the options available in Assisted Living are vast, and many are resort style full of vibrant residents engaging in a calendar full of daily activities, chef prepared meals, groups, and outings, still living their best life with a little help.Taking a look at what makes up a quality Assisted Living Community, I found some good insights from an article by Dr. Steven Fuller, DO, PhD Seven Challenges Assisted Living Must Get Right - Caring for the Ages that would like to share parts of along with some professional experience working as a Senior Living Advisor for Ruby Care.Integrated CareQuality of health care must be at the center of any assisted living community, as declining health is the main reason for residents to move to assisted living. On the flip side, it is also the top reason for residents to leave assisted living.TransitionsChallenge for many people is failure to recognize that health care is managed in acute care settings (like hospitals) differently than in chronic care settings (like assisted living). The goal of hospitals is short term, standardized treatment of a residents illness or episode of care. In the hospital setting, the forming of nurturing and healing relationships often falls victim to fast-paced efficiency to reduce the length of stay and cost of care.In assisted living, however, the opposite prevails. The emphasis has evolved from treatment of an illness to recovery from the illness. Residents are now moving to a new home environment where relationships and person-centered care are paramount as well as continued recovery and care. AcuityIdentify limitations of individual communities on resident acuity that can be competently managed (Type A vs Type B). The consequences of accepting a resident whose health care acuity exceeds the ability of workers capacity to manage it endangers the existing residents by diverting staff and other resources toward the highest acuity residents, leaving the lower acuity residents with unmet health care needs.  Many assisted living communities have levels of care and hire staff based on the acuity level of the resident population. These levels of care come with increased cost.Chronic Disease ManagementAssisted living residents have multiple chronic diseases and take a multitude of medications to treat them. It is a significant challenge managing the delicate balance of medications to obtain optimum outcomes. How the assisted living schedules necessary tests and appointments for residents, arranging transportation, distributing/renewing prescriptions, communicating with families, and so on are all key things to know and ask.Managing chronic illness is a challenge. Many communities have helped provide better management by having concierge physicians that can make house calls and tele-med visits at the community.  This is even more prevalent since the past 2 years with COVID, to ensure that residents can receive quality medical care with minimal risk of exposure or transmission. This also allows the senior to remain in a comfortable/familiar environment reducing overall stress and anxiety.Quality MeasuresAssisted living communities must be able, upon request, to objectively validate the quality of the health care they are providing to their residents. Health care data should be collected, tracked, analyzed, and communicated to employees and families. Examples of important quality measures include emergency department transfers, hospitalizations, readmissions, falls, pressure ulcers, behavioral disturbances, pain control, ambulance calls and transfers, and resident and employee satisfaction surveys. Note that not all assisted living options are licensed and state regulated. All potential communities should still be checked to ensure that they are following best practices and federal guidelines regarding all quality measures. State regulated communities can be checked for any violations on the HHS Texas,gov site.FallsHow does the community work to help prevent falls?  Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a broken hip or head injury. Additionally, falls are a leading contributor to liability costs, which are then passed down in the rent paid by all residents. For more information on falls and how to prevent them refer to our previous blog: https://rubycaresenior.com/blog/f/how-to-prevent-fallingAs you can see, there is a lot to consider when thinking about Assisted Living and living out your or your loved ones best life possible.  When the time comes for you to look for Assisted Living or other Senior Living options, there are many senior communities available capable of providing quality and the continuity of care needed. Finding the right one can be a daunting task, with over 900+ in the DFW area. At an often already stressful time, enlisting the expertise of a Senior Living Advisor from Ruby Care can ease the stress.  We can be your guide to helping navigate the sea of available options based on what would be the best fit given the individuals care needs, financial constraints, likes/dislikes, location, family support available, etc. We even set up and tour with our clients, all at no cost to you! Our team is passionate about seniors in our community, and love what we do!Britt Hemsell  Ruby Care Senior Living Advisor & Blog ContributorResources: https://www.caringfortheages.com/article/S1526-4114(19)30325-7/fulltexthttps://apps.hhs.texas.gov/ltcsearch/providersearch.cfmAlzheimers Association  www.alz.org

Originally Posted September 15, 2023Long-term care facilities, also referred to as Nursing Homes Working to improve the quality of care for elderly residents, the Biden Administration has given CMS the authority to implement new regulations that mandate nursing homes participating in Medicare and Medicaid to maintain minimum staffing levels and promote transparency.  Outlined in a report from The White House, the new regulations target the long-standing concerns of understaffing and the impact it has on the quality of life and care of vulnerable residents in nursing homes. In this blog, we will discuss implications of the new rules and their potential to make an impact on long term care in the United States. Understaffing ProblemFor years understaffing has been an ongoing issue in U.S. nursing homes, with consequences being inadequate care to elderly neglect and abuse.  The COVID-19 pandemic called attention to the vulnerabilities our loved ones face in these facilities, over 200.000 lives were lost in long-term care facilities (npr.org), which prompted a call for systemic change.  As nursing homes struggled to cope with the demands of the pandemic, the need for more personnel and better staffing ratios became glaringly evident.   New Regulation FocusThe Centers for Medicare & Medicaid Services (CMS) has introduced new regulations requiring nursing homes to meet minimum staffing requirements, in an ongoing effort to improve the quality of care for Medicaid and Medicaid recipients and are expected to have a profound impact on the industry. New Regulations Key Provisions   Minimum Staffing Levels: Nursing homes are now required to maintain a minimum staffing level, ensuring there are enough nurses and other staff members to meet residents needs adequately. These levels will vary depending on the size and needs of the facility.  Staffing Ratios: Facilities must now have an appropriate number of registered nurses (RNs) on staff 24/7 to provide skilled nursing care to residents.  Transparency: Nursing homes must be transparent about their staffing levels and retention, making this information readily available to residents and their families.  As staffing levels and turnover have shown to be directly correlated with quality of care1.  CMS database of nursing home owners and operators.2.  Improve transparency of facility ownership and finances.3.  Enhance nursing home Care Compare rating website.4.  Examine the role of private equity investors in the nursing home sector Accountability: CMS will enforce these regulations through regular inspections and assessments. Nursing homes failing to meet the requirements may face serious penalties of lose their eligibility to Medicare and Medicaid fundingPotential Impact There are several positive changes these new regulations are expected to make in the long-term care industry  Improved Quality of Care: Appropriate staffing levels mean better care for residents, as their needs will be addressed more promptly.  When a residents need is met in a timely manner it can lead to preventable medical complications and overall improvement in the residents quality of life. (PubMed)  Improved Resident Safety: Incidents of neglect and abuse may decline with more staff members available, ensuring a safer environment.  Better Staff Retention: CMS is investing $75 million in financial incentives, in things like tuition reimbursement to help improve retention at nursing homes. (npr.org) When a facility is staffed adequately it can reduce burnout and stress, leading to less staff turnover and hopefully as a result will attract more skilled professionals to the industry.  Informed Choices and Transparency: Nursing Home Five-Star Rating System will aid families in making informed decisions when choosing a facility for their loved ones.  Government Accountability: Oversight and government enforcement are critical in ensuring nursing homes are held accountable and lead to systemic positive changes.Challenges and ConcernsImplementation: Due to nationwide shortages in nursing and healthcare supportive staff, nursing homes participating in Medicare and Medicaid may struggle to meet the new regulations standards.Costs: Hiring additional staff equates to increased costs which are often passed on to the residents. The American Health Care Association believes that the proposal will worsen current conditions and cost nursing homes billions. (Associated Press)Monitoring and Enforcement: Effectiveness of the new regulations will rely on regular monitoring and enforcement by CMS. With 75% of nursing homes nationwide being impacted, this could potentially lead to closures and additional struggles, especially in remote areas. (Associated Press)Not Enough: Leader of Long-Term Care Community Coalition, Richard Mollot, called the measures completely inadequate. While admitting that the 24/7 nursing requirement may make small improvements in some of the worst facilities. (Associated Press)There is no question that we all want quality care in a safe environment for our elderly and loved ones.  While there will be many challenges to overcome implementation, the benefits in enhanced quality care, resident safety, and transparency outweigh the concerns. Only time will tell if these new regulations will truly be able to aid nursing homes in making changes that yield positive long-term outcomes for residents. Families being able to make better and more informed choices as to where their loved ones receive care is a step in the right direction. After decades of caring for loved ones, there is nothing that can compare to having a family member or friend that checks in on their person regularly. Being present and knowing youre coming has a positive impact not only on the residents but the staff too. Long-term care is a team effort and taking an active role to be a positive part of that team can make a significant difference.  'Britt Hemsell | Senior Living Advisor & Blog ContributorResources:The Associated Press by Matt Sedensky: reader.dallasnews.com/infinity/article_popover_share.aspx?guid=87cfddf9-73c6-4259-a88b-e6e912921658The White House: FACT SHEET: Biden-Harris Administration Announces New Steps to Improve Quality of Nursing Homes | The White HouseNPR: Biden New Federal Standards for Nursing Home Care : NPRPubMed: The association between nurses' burnout and objective care quality indicators: a cross-sectional survey in long-term care wards - PubMed (nih.gov)

I recently found myself having to decide between a skilled nursing facility or inpatient rehabilitation center when it was time for my 104-year-old grandmother to be discharged from the hospital.  Here she was doing well, and ready to transfer out of the hospital setting, but not strong enough to go back to her apartment in independent living. How does one make the decision to go to one over the other? What are the pros/cons? Where will your loved one be the safest and get the care needed to regain strength and make it back home? These are questions that run through ones mind and need to be answered when making this type of decision.  While it is best to work on prevention to avoid a hospital stay in the first place, its good to know that there are options available that can help one transition between the hospital and home.Remember that the number one cause of injury for seniors is due to falls. (CDC.gov) See our blog for information on How to Prevent Falling How to Prevent Fallin... (rubycaresenior.com)Skilled Nursing Facilities and Rehabilitation Centers are great transition options.  Medicare often required a min 3 day hospital stay before qualifying to stay at a Skilled Nursing Facilities and Independent Rehabilitation Centers. (cms.gov)Skilled Nursing Facility (SNF)Definition: Skilled nursing is a term that refers to a patient's need for care or treatment that can only be done by licensed nurses.  Skilled nursing is mostly regulated by the U.S. Department of Health and Centers for Medicare & Medicaid Services (CMS). To be certified by CMS, skilled nursing communities must meet strict criteria and are subject to periodic inspections to ensure quality standards are being met. Often referred to as a nursing home although that actually refers to the actual building that skilled nursing is provided. (verywellhealth.com and harrogatelifecare.org)The focus of care in SNFs is on 24/7 medical care, assistance with activities of daily living (ADLs), and rehabilitation for those who require ongoing medical care.Types of patients that go to SNFs typically require ongoing medical care, such as those needing wound care, healing from surgery, or chronic medical conditions.One will typically have a longer stay, often a few weeks to months, when in a skilled nursing facility. Rehabilitation therapy is required 5 days a week, but not as intense. Services covered by Medicare:  Meals 24/7 Nursing available Activities of Daily Living (ADL) assistance physical, occupational therapy, speech therapy medication management social services medical equipment (DME) ambulance transportation to a medical facility for additional services needed when not available at the skilled nursing facilityServices NOT covered by Medicare: palliative or hospice care services or long-term care needs.  (Hospice care services are covered once rehabilitation is no longer an option and end of life is needed).Inpatient Rehabilitation Center (IRF)Definition: Inpatient Rehabilitation Facilities (IRFs) are freestanding rehabilitation hospitals and rehabilitation units in acute care hospitals. They provide an intensive rehabilitation program and patients who are admitted must be able to tolerate three hours of intense rehabilitation services per day. (cms.gov)The focus of care in an inpatient rehabilitation facility is on rehabilitation and helping patients regain independence and mobility.Types of patients that typically go to an IRF are those who have had a recent injury, illness, or surgery that requires intense rehabilitation to regain their ability to function independently.One typically has a shorter stay of days up to several weeks and is required by Medicare to participate in a min of 3 hours a day or min of 15 hours per week of therapy (Physical/Occupational/Speech).Who helps me decide where to go?The Hospitalist  This is the internal Medicine doctor that oversees patient care while staying in the hospital. They will often make a recommendation.Case Manager (Hospital) Assigned to the patient to aid in navigation the transition from the hospital to SNF, Rehab Center, or home. If going directly home, they would also assist with Home Care options and DME.Terms Rehabilitation  Short or Long-term inpatient rehabilitation is often covered under insurance after a serious surgery or injury. This can help not only provide daily therapy, but also provide a family caregiver some respite or allow for the injured party to gain some strength and mobility back before returning home. Physical Therapy - Often covered by insurance. One can receive physical therapy to help build overall strength and mobility of the area that was impacted. Services can be given in the hospital, skilled nursing, rehab, outpatient setting, or through Home Health. Occupational Therapy  This type of therapy is great for helping to discover new ways to do everyday activities that have become more challenging since an injury or fall. Typically covered by Insurance. Services can be given in the hospital, skilled nursing, rehab, outpatient setting, or through Home Health. Speech Therapy  This type of therapy is great for making sure swallowing, eating, drinking, and talking are all in good working order after surgery, injury, or serious illness. Is often covered by insurance, and services can be given in in the hospital, skilled nursing, rehab, outpatient setting, or through Home Health.Care Assistance Home Care  Bringing in some assistance temporarily while recovering can help take the load off the day-to-day chores and assist with Activities of Daily Living (ADLs), allowing you to focus on healing and getting stronger. This is often private pay unless you have long-term care insurance or qualify for VA benefits.While both SNFs and IRFs provide 24/7 medical care and rehabilitation services, they differ in what they focus on regarding the patients that they admit and the intensity of the rehabilitation services they offer.What happened to grandma? Based on her level of energy and weakness due to her illness and the fact that it would take another week for her to start getting some energy back, it was decided the best choice would be a Skilled Nursing Facility. The 3 hours a day therapy requirement would have been too much at the time for her to endure.  Happy to report she is truly remarkable and making good strides toward a full recovery. Go grandma go!Britt Hemsell  Ruby Care Senior Living Advisor & Blog Contributor

Parkinsons: What do I need to know?April is Parkinsons Awareness month, with April 11 being World Parkinsons Day.  Parkinsons is a type of dementia that impacts motor function and is degenerative.  Currently there is still no known cure for Parkinsons disease.   What is Parkinsons disease?According to the International Parkinson and Movement Disorder Society (movementdisorders.org), Parkinsons disease is a neurogenerative disorder characterized primarily by the loss of dopamine neurons in the substantia nigra part of the brain. SymptomsGenerally, symptoms develop on one side slowly over years, but the progression may differ due to the diversity of the disease.  People with PD may experience the following:   tremor, mainly at rest (described as pill rolling tremor in hands  bradykinesia  limb rigidity  gait and balance problems.Non-motor symptomsCommon Neuropsychiatric symptoms are:   mood disturbances  cognitive changes  autonomic dysfunction  pain  sleep issues  anxiety  apathyPrevalence is approx. 200 cases in 100K population, and about 25 cases per 100,000 population.  When motor manifestations appear, people with PD have lost more than 50% of nigral dopamine cells suggesting that pathological changes may begin several decades before the appearance of clinical signs.  Causes of Parkinsons diseaseIt is believed that Parkinsons disease is multifactorial. Contributing factors are:  Hereditary predisposition  Environmental toxins  Aging  Genetic mutations (GBA, LRRK2, PRKN, SNCA)DiagnosisDiagnosis is still clinical and based on motor manifestations.  A brain MRI or CT and molecular imaging of the striatum may be performed to support clinical evaluation.TreatmentLevodopa has remained the cornerstone of PD treatment for more than 50 years.  The challenge is after a few years of treatment the benefit lessons and motor complications appear in many patients due to disease progression.  The introduction of many other medications including inhibitors and dopamine agonists have been developed due to this decline.  More recently, surgical and infusion therapies have become available to improve management in selective patients with motor complications. Surgery options include:  deep brain stimulation.  drug infusions based on the possibility to deliver continuously either levodopa or apomorphine.Treatment noted is based on research according to Marcello Merello, MD Director of Neuroscience Dept. Head Movement Disorders Section Institute for Neurological Research Raul Carrea (FLENI) 2019 Updated by Angelo Antonini, MD, PhD Professor, Department of Neuroscience University of Padula, Italy.Parkinsonism (movementdisorders.org)A defining feature of Parkinsonism is bradykinesia (slowness with decrement and degradation of repetitive movements (Fatigue). Subtle bradykinesia is known to occur in the normal elderly population. The most common neuro degenerative cause of parkinsonism is Parkinsons disease.  Other causes include multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration.  Often called Parkinson-plus syndromes, they do not respond as well to dopaminergic treatments and generally have worse prognosis compared to typical PD. Parkinsonism can also be symptomatic because of various vascular drug related, infectious, toxic, structural, and other known secondary causes.  Vascular Parkinsonism tends to have a lower body emphasis with gait disturbance and concomitant cognitive impairment.Where to get helpWe are fortunate to have a Dallas Area Parkinsons Society (DAPS).  The DAPS provides not only information, but also hosts exercise groups and activities throughout the metroplex.  Several churches and senior centers also host Parkinson support groups and wellness classes. Dallas Area Parkinson Society | Home (daps.org)Parkinson's Disease Support Groups (verywellhealth.com)  American Parkinson Disease Association  DailyStrength Parkinsons Disease Support Group  Parkinsons Foundation  PatientsLikeMe  Parkinsons Movement Disorder and Alliance  Parkinsons Community  NeuroTalkAdult Day Cares and Assisted Living Communities often provide respite services for those with Parkinsons or other conditions requiring activities of daily living (ADL) care support.How can I help?The Michael J Fox organization provides free scratch and sniff tests that help researchers learn more about Parkinsons risks and contribute to research on the disease. (michaeljfox.org)Regardless of if you are reading this because you or a loved one has been impacted by Parkinsons disease or if you are just wanting to learn more, we hope that you are able to get the support you need and/or find ways to help cope Britt Hemsell  Ruby Care Senior Living Advisor & Blog ContributorResources:International and Movement Disorder Society https://www.movementdisorders.org7 Parkinson's Disease Support Groups of 2023 (verywellhealth.com)American Parkinson Disease Association  https://www.apdaparkinson.org/community/Dallas Area Parkinson Society | Home (daps.org)Some Adult Day Cares in DFW:  Friends Place Adult Day Care Richardson 972-437-2940

Boarding Home and Residential Care HomeWhen it comes to finding care options for loved ones or individuals needing assistance, navigating the various types of facilities available can be overwhelming. With the baby boomer population continuing to age, more seniors will be needing to seek out options that provide companion services and higher levels of care.  One of the potential options includes group homes. Municipal regulation of Group homes  states, While there is no single definition of group home under state of federal law currently, under Texas law there are at least 24 types of homes, houses, centers, and other facilities, probably more that may qualify as a group home. Confusing, right? There are many types of group homes that provide housing, counseling, and programs for teens, drug addiction, mental and physical disabilities, and conditions. For the purposes of this blog, we will focus on two types of group homes that cater to adults and seniors needing assistance: Boarding and Residential Care Homes. Boarding homes and residential care homes are often confused, both cater to specific needs and offer distinct levels of care.  Understanding their differences is crucial in making an informed decision to individual requirements.Boarding HomeAccording to the Texas Health and Safety Code Section 260.001 a boarding home is classified as:  Serves elderly persons 65 and up or persons with disabilities (mental, physical, intellectual, or developmental) that impairs the persons ability to provide for ones care or protection  Provides lodging to three or more persons with disabilities or elderly that are unrelated to the owner of the home  Provides meals, housekeeping, transportation, grocery shopping, money management, laundry services, self-administration of medication assistance  Does NOT provide assisted living facility (ALF) personal care services as defined in Section 247.002  County or municipality may require a permit to operate  May have coverage under certain government programs or a long-term care policyThese homes offer a smaller environment and up to 6 residents live in a home-like setting with trained staff and supervisors that often live in the home.Residential Care HomesDefinition: A residential care home, also referred to as community, personal care home, or board and care home, is a private home that usually house 20 or fewer residents (some as few as 3 or 4) that are staffed 24/7, deliver non-medical assistance to seniors that do not need 24/7 nursing care. Services include meals, personal assistance with daily activities of living.  Homelike environment with private or semi-private rooms  Assistance with activities of daily living (ADLs) such as: bathing, dressing, and medication management  Social activities, meals, and basic medical assistance provided  Often more affordable than traditional and larger assisted living facilities  Caregiver to patient ratio is typically better than in standard assisted living facilities  Cost is private pay, long-term care insurance, or Veterans assistance programs  Supportive care services such as home health, therapy, and hospice care can be provided by a licensed third-party service provider  Unlicensed Residential Care Home is allowed up to 3 non-related residents (Legal & illegal)  Licensed homes are certified by Texas Health and Human Services for compliance at the state and federal level.   A very small number of care homes accept MedicaidThe Texas Health and Safety Code Section 123.005 notes that community homes can provide a wider array of services such as: food, shelter, personal guidance, care, habilitation services and supervision services to persons with disabilities compared to boarding homes. These disabilities can include Alzheimers or other types of dementia; autism; mental illness; muscular dystrophy; multiple sclerosis, among others. Section 123.002Residential Care Homes can be Licensed as a Type A or B Assisted Living Facility (ALF):Type A  Requires the resident to be physically and mentally capable of evacuating the facility unassisted in an emergency. They do not need regular assistance during sleeping hours.Type B  Residents may require assistance to evacuate and may be incapable of following directions in an emergency. Often require attendance during nighttime hours.When considering a Residential Care Home, it is important to find out if they are licensed or not and what level of services they provide.  If not licensed, are they operating legally and following state and federal guidelines for operations? What levels of care can they provide?  It is advisable to enlist the help of a Senior Living Advisor like Ruby Care Senior Living Advisors, as they can narrow down your search and ensure that you know what you are walking into versus wasting time on numerous homes that may not be a good fit or even worse operating illegally.  With many different care options to choose from, making the decision as to what is the right care setting involves considering the specific needs, level of independence, and medical requirements of the individual. A group home such as a residential care home may be just what you and your loved one are looking for to provide quality senior care when the time comes. Knowing one has options outside of a traditional assisted living facility or nursing home empowers individuals and families to make informed decisions based on the needs and preferences of their loved ones.Author: Britt Hemsell | Senior Living Advisor & Blog Contributor