Meals on Wheels of Boulder is offering a new service to Boulder area residents: Project Homecoming, a short-term meal delivery program designed to help patients make the transition from hospital to home.A 2006 study conducted by UC Berkeley Health Research for Action (From Hospital to Home: Improving transitional Care for Older Adults) found care transitions to be an increasingly critical health and social problem for seniors and their caregivers. In addition, some seniors are at very high risk for rehospitalization and increased morbidity and mortality after discharge a situation which puts added and unnecessary stress on the health care system.Hospital homecomings can be stressful even under the best conditions, perhaps in part because a surprising number of all patients may not know where their first meals will come from once they're home. Many are sent home with new dietary restrictions which may be difficult and confusing. Receiving healthy meals can help smooth the transition, relieve anxiety and help patients get well faster. While the study cited refers to seniors, the service from Meals on Wheels of Boulder is designed for patients of any age or income level being released from hospitals or rehabilitation facilities to their homes in the Boulder area, specifically those who do not have immediate plans to provide food for the first five days. It includes a hot meal, delivered at noon, prepared to meet any dietary restrictions delivered by Meals on Wheels volunteers for five days. Frozen meals are available for weekends.The cost of the service? Its free for the first five days with absolutely no strings attached!We plan to add an educational component this year, said Francea Phillips, executive director. Well be working with a dietician to prepare guidelines for patients with some of the most common restricted diets, such as no added salt, no concentrated sugars, low fat, low calorie, and high protein, to name a few.Meals on Wheels of Boulder was founded in 1969 and has delivered more than 1.5 million meals in the past 40 years. Demand for services has increased steadily at about 15% for the past four years, with an enormous increase in need for food among those in the lowest income brackets. Meals on Wheels of Boulder has no waiting list and will not deny food regardless of age or income to any qualified individual in Boulder.For more information about Project Homecoming or any services, please call 303-441-3908, visit www.mowboulder.org, or email info@mowboulder.org.

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If you were living in a nursing home or an assisted living home anywhere in the country, from Florida to Oregon to New Hampshire, you have access to a local Long Term Care Ombudsman. The Ombudsman is an independent confidential resident advocate. The Ombudsman works to empower residents in the resolution of their concerns or complaints and works to protect the rights of the residents. The Ombudsman works with families too and supports the development of Family Councils. The Ombudsman confers with staff on resident rights, provides educational in-service trainings.Resident rights include the right to: be treated with dignity and respect; to have privacy and confidentiality honored; to participate in decisions about care; to make independent choices; to raise concerns and complaints without fear of retaliation; to appeal a notice of a discharge from a nursing home.Long Term Care Ombudsmen promote resident-centered care, meaning that the voice of the resident is sought, is honored and respected. How would you recognize resident-centered care? Here are just a few examples. Staffing: do the care giving staff care for the same group residents each time they work? Yes, allows for the caregivers to remember the routines and preferences of each individualized resident and provide individualized care. Morning routines: can the resident be awakened in the morning according to their lifelong pattern? Yes means that staffing practices follow the residents preferences rather than the other way around. Recreational activities: what type of activities are offered here? Scheduled activities that are based on current residents interests, provided 7 days a week, improves quality-of-life.Call the Ombudsman for: Information on options before a choice of a facility is made Talking through a concern or a complaint Assistance in resolving a complaint Attendance at Care Plan meetings where care goals are reviewed Educational presentations to residents, families, staff on: Resident Rights, Role of an Ombudsman303-441-1173 is the confidential Boulder County Long Term Care Ombudsman

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Life Testaments, or ethical wills, are a way to share our values, blessings, life's lessons, hopes and dreams for the future, love, and forgiveness with our family, friends, and community. Although these names frequently cause confusion, Life Testaments are simply writings intended to provide loved ones with more formal and tangible expressions of those values, guiding principles, and wishes than conversations that may be planned but never held. Life Testaments are not new. Their use may be found, for example, in both Hebrew Scriptures (Genesis 49) and Christian Scriptures (John 15-18) and may be transmitted orally or otherwise. If in written form, they are not considered legal documents in the sense that they do not convey wishes in the event of a terminal condition or irreversible coma as may be found in a Living Will; nor do they express wishes as to materials possessions as may be found in a Will or Revocable (Living) Trust. Rather, they are personal expressions of values at life's turning points, responses to challenging life situations and transitional life stages. These personal documents reflect the voice of the heart and are as unique as the person writing it. Life Testaments share some common themes: Preserving family history; conveying important personal/spiritual values and beliefs; bestowing hopes and blessings for future generations; relating life's lessons; expressing ones love, forgiving others, and asking for forgiveness. Couples and parents may use a Life Testament to help clearly understand each others values so to build a foundation of common values for the relationship and childrearing, as well as to launch adult children and enter into a new relationship phase; an opportunity to harvest life experiences, convert these experiences into wisdom, and allow for the fulfillment of the responsibility of passing this wisdom on to future generations. Each of us may use the Life Testament as a link to future generations, a legacy of values and beliefs for a time when we are gone. A Life Testament complements our estate plan will or trust, durable general and healthcare powers of attorney, living will. It is a living document, ever changeable, constantly evolving; a challenge to create, a relief to complete; a blessing to give.Editors Note: This article was submitted by Dan Kapsak of Kapsak Law Firm LLC. He may be reached at 303 651-9330 or by email dkapsak@kapsaklaw.com

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Do you know the differences between Home Care Agencies, Home Care Placement Agencies, and Independent Home Care Workers? Knowing these key differences can help you, or your loved one, get the care you need while protecting yourself from liability. First, some definitions: Home Care Agencies employ trained staff who provide medical home health or non-medical personal care services in the home care consumers temporary or permanent home or place or residence. Home Care Placement Agencies (a.k.a., registries) make referrals of Independent Home Care Workers to home care consumers seeking services. Independent Home Care Workers are unaffiliated individuals who may or may not have home care training who hold themselves out to the public as providing home care services.In order to better ensure the safety of home care consumers, Gov. Bill Ritter signed legislation in the summer of 2008 requiring all Home Care Agencies to be licensed by the State of Colorado. This new law requires that all medical Home Care Agencies become licensed prior to January 1, 2010 and all non-medical Home Care Agencies become licensed prior to January 1, 2011.In order to become licensed, Home Care Agencies must comply with a significant set of requirements that are designed to protect the rights and safety of home care consumers. These requirements include carrying general liability insurance or a surety bond, and training, scheduling, supervising, disciplining, and performing background checks on all home care workers. Home Care Agencies must also pass an extensive onsite survey by the State of Colorado Department of Health. As the employer of record, Home Care Agencies are also required to withhold and remit federal and state income taxes, Social Security and Medicare taxes, and provide unemployment insurance and workers compensation insurance for all home care workers.By comparison, since they are not legally the employer of the home care workers whom they refer, Home Care Placement Agencies are not required to withhold payroll taxes or provide unemployment or workers compensation insurance for those home care workers. This means the consumer can be held directly and personal liable for any unremitted payroll taxes and any medical expenses should a referred home care worker become injured while providing care for the consumer. Likewise, since they are not the employer of record, Home Care Placement Agencies cannot be required to train, schedule, supervise, or discipline their referred home care workers. Generally speaking, because Home Care Placement Agencies are not able to exercise management and control over the performance of their referred home care workers, the State of Colorado does not currently allow Home Care Placement Agencies to become licensed.While some Independent Home Care Workers choose to accept referred assignments from Home Care Placement Agencies, others choose to work exclusively on their own. For those working on their own, all background checks, training, scheduling, supervision, and discipline become the responsibility of the consumer. And, as in the case of Home Care Placement Agencies, the consumer can be held directly and personal liable for any unremitted payroll taxes and any medical expenses should an Independent Home Care Worker become injured while providing care for the consumer. Caveat Emptor. Consumers are strongly encouraged to request an Agency Disclosure Form, which the Colorado Department of Health requires all Home Care Agencies and Home Care Placement Agencies to provide to consumers, and which specifies whether a provider is a Home Care Agency or a Home Care Placement Agency and lists the consumer safeguards that the home care provider is responsible for as well as the responsibilities of the home care consumer.Editors Note: This article was submitted by Lorin Chevalier, Managing Director of the licensed Home Care Agency, Senior Helpers, and a member of the Home Care Association of Colorado, the National Private Duty Association, and the Colorado Gerontological Society. He may be reached at 303-452-6500 or at www.SeniorHelpersBoulder.com

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