As well-known speakers on the issue of eldercare, my partner and I are involved in many vital and meaningful discussions around aging population. What we’ve discovered is that sometimes the issues around our elderly are vast and complicated (like Medicare and the Healthcare Reform Act) – and sometimes the issues that touch the aging most intimately are the simplest things. One of those simple issues is TOUCH. We hear about touch as a medium for healing in so many arenas of life – in premature infants, seriously ill and even terminally ill patients.

As advocates of for healthy, wonderful resources in eldercare, eCareDiary hopes to move this conversation to the top of the list for the aging population. As a society, we may be powerless over many issues facing our aging parents and grandparents, but this is ONE thing that we can simply and easily bring back into their lives.  It is only a question of awareness.

Why? The reasons our aging population grow physically more and more isolated are vast. To begin with, it’s common that they will have lost those who were closest to them – their spouses, best friends, siblings – in some cases, even their children. It’s also possible that we, as care providers, are so conscious of being aware of their frailty, that we go too far – hardly touching them at all. Even hugging them from an invisible half-inch boundary becomes our norm.

What to do. There are so many simple ways to reengage ourselves with the elderly population. For daughters, granddaughters and female care providers, sometimes the simple act of providing a manicure or pedicure is a restorative physical connection. For myself, the opportunity to shave my dad was always a fond intimacy between us – and a way for him to feel good about himself.

What are the benefits. According to the Touch Research Institute, elderly massage is one of the most useful treatments for all levels of Alzheimer's patients. It’s been shown to facilitate relaxation and even communication. Touch can also greatly assist in pain management and can also create an increase in strength and muscle awareness. (And all things being connected, this can help the elderly population to avoid falls and other injuries, simply because their bodies grow weaker or less self-aware over time.)

Finally, touch can also have a profoundly calming effect – which can help the patient to deal with medical and lifestyle interventions much more easily and in a way that is more deeply connected to their loved ones and care providers. In short, touch can be a bridge that breaks their isolation. This is even more true when the patient may have lost their verbal abilities for one or more reasons.

As our patients and loved ones move into their golden – and even their platinum years, bringing the intimacy and caring of touch back into their lives – and even into OUR lives – is a strong and powerful connection that we should definitely not overlook. After all, even the powerful healing of a simple hug can make all the difference in a person’s day.

John Mills, Co-Founder of eCareDiary
http://www.eCareDiary.com

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Caring for Dementia Patients Is Stressful and Isolating – A study from Pennsylvania State University found that caregivers of dementia patients were highly stressed and more likely to suffer from depression and potential mental breakdowns.

New Alzheimer’s Vaccine To Be Tested in Europe – A vaccine developed by Austrian biotechnology company Affiris will be tested in 6 European countries with 420 participants in the trial. The vaccine works by attacking the plaque which is known to cause Alzheimer’s disease.

Domestic Robot May Help Seniors Live Independently – European researchers are linking domestic robots with smart homes fitted with sensors and monitoring devices in an effort to help seniors live independently longer.

New Blood Test Could Help Tailor Treatments for Rheumatoid Arthritis – A simple blood test can help identify which immune system antibodies can be used to treat suffers of Rheumatoid Arthritis.

As any family with a loved one who is “aging in home” probably knows, finding home health aides who are not only qualified, but also passionate about their work is not easy. There are many, many variables that come into play – after all, this person has access to your home, your family, and your precious parent or grandparent. 

To make matters more difficult, your loved one has quite possibly lost their ability to advocate for themselves. So the home health aide you choose MUST be well above board. 

I faced these issues over and over again, as we chose – and UNchose – almost a dozen home health aides while caring for my father. Although we finally found a wonderful person to help us, trodding through agencies and aides not only affected our careers and schedules every day – it made it almost impossible to do the basics of life. Even going to work or getting out to buy groceries became a measure in frustration when the home health aide didn’t show up or wasn’t the person we’d planned on.

And that’s not even touching on how confusing it is to the patient themselves. This issue filled our whole family with stress and worry – after all, this was our precious dad. the one who had been there every day of my husband’s life. How could we entrust his care, at the most vulnerable time in his life, to the wrong person?

There are some important criteria to keep in mind when you’re looking for a home health aide and agency. There are certifications and professional trainings that you should be aware of. We have attached a list of 10 criteria and questions to keep in mind at the end of this article.

But the OTHER qualifications – the human side of someone… definitely take the time and be sure that your care provider has the qualities that are most important to you and your family.  Sit with everyone in your household and ask them what those are. Remember that the extra time you put into this process at the beginning can save you countless hours of frustration and disappointment down the road.

10 Criteria for Choosing a Home Health Aide

Once you acquire the names of several providers, which you can do on our website under the CARE PROVIDER feature, you will want to learn more about their services and reputations. Here are 10 questions to consider as you make your decision:

A few weeks ago President Obama signed into law a new healthcare reform bill which will expand health insurance coverage for 32 million people who are currently uninsured.  This law will be phased in over the next decade but it offers a lot to help family caregivers both in the short term and the long term.

The benefits of the law fall into two categories – provisions which help the care recipient through Medicare and other public programs and those that help the caregiver through expanded health insurance coverage and better consumer protections.  The biggest advantages to care recipients come through better coverage under the Medicare prescription drug program and through expanded health insurance options for pre-Medicare retirees.

Family caregivers will see their biggest benefits come from the fact that health insurance will begin to be de-coupled from employment starting in 2014.  Many family caregivers face the difficult choice of whether to stay employed and hire professional caregivers to look after their loved ones or to leave their jobs and care for them full time.  This decision is made more difficult by the fact that people who leave their jobs risk losing the health insurance benefits that go with them.  By providing new health coverage options and subsidies to help pay for them, family caregivers will have one less thing to worry about when making these difficult choices.

Brain Images Suggest Alzheimer's Drug Is Working – New image technology suggests that Bapineuzumab, a new Alzheimer’s drug, is working.  Studies show the drug reduces clumps of plaque in the brain by 25% which is important because plaque is an underlying cause of Alzheimer’s. 

Ibuprofen May Reduce Parkinson's Risk – A new study from Harvard University has found that taking Ibuprofen may reduce the risk of Parkinson’s disease.  The research showed that people who took three or more Ibuprofen tablets a week had a 40 percent lower risk of contracting the illness than those who didn't take it.  
 

Video Games May Help Battle Depression in Seniors – A new study has found that “exergames,” video games that combine game playing with exercise, can help improving the symptoms of subsyndromal depression (SSD).  
 

Rapid Image Analysis Method Helps Diagnose Alzheimer's Disease – A study from Finland has found that MRIs of the brain can be used to diagnose Alzheimer’s quickly.  Up until this study, diagnosis of Alzheimer’s has been done by review of the symptoms without the aide of brain images.
 

Editors Note - Caregiver News Roundup will now be appearing every 2 weeks.

Industrial Chemical Linked to Increased Risk of Getting Parkinson’s – A new study has found that exposure to the industrial solvent trichloroethylene increases your risk of coming down with Parkinson’s disease by six times.  Trichloroethylene is an industrial cleaner used in dry cleaning, machine shops and in the manufacture of electrical equipment.

Diabetes Drug Increases Risk of Bone Fracture in Older Women – A study has found that women over age 65 who take thiazolidinedione, a drug to treat Type 2 diabetes, were 50% more likely to suffer bone fractures than women not taking the medication.

57 Million Americans Sickened by Swine Flu – The Center for Disease Control estimates that 57 million Americans have come down with the Swine Flu since April 2009.  

Blood Test May Be Able to Predict Rheumatoid Arthritis – A study has found that blood tests maybe able to detect rheumatoid arthritis years before symptoms appear.  This information make it possible for doctors to identify the disease early and help find the most effective treatments for each patient.

Truth about Heart Disease: There Is No Cure – Heart disease is the number 1 cause of the death in the US and as former President Bill Clinton’s stent procedure shows that while it can be treated there is no cure for it.

FDA Wants to Reduce Radiation Exposure in Medical Tests – The Food and Drug Administration has announced a plan to reduce patient’s exposure to radiation in 3 tests – CT scans, nuclear medicine studies and fluoroscopy.  Medical advances over the past 20 years have resulted in a dramatic increase in radiation exposure from tests.

Marijuana Ineffective as a Treatment for Alzheimer’s Disease – A new study from Canada has found that marijuana is not effective at combating the effects of Alzheimer’s Disease.

Being a caregiver is an incredibly stressful experience and a new study by the MetLife Mature Market Institute has some startling conclusions about its impact.  The report examined employees serving as caregivers and found that they are more likely to suffer from health problems like diabetes, high blood pressure and depression than their co-workers.

Some of the key findings in the study include:

• Caregivers have health costs which are 8% higher than people who are not caregivers and cost employers $13.4 billion a year.

• Employees serving as caregivers were more likely to report poor health than their co-workers.  For example, 17% of female employees ages 50 and older who were caregivers reported fair or poor health compared to 9% of non-caregivers.

• Employed caregivers find it difficult to take care of their own health care needs and are less likely to get preventive care such as mammograms, annual physicals and preventive health screenings.

One In Five Nursing Homes Has Poor Quality Ratings – According to Medicare, 20% of nursing homes have poor quality of care and receive one or two stars out of five in the Medicare ranking system. 

How Doctors Can Assist Caregivers – Doctor’s can help caregiver by asking them questions not just about the patient but also the caregiver’s health, needs and well being.

Brains in Older People Are Good at Sorting Out Useless Information – A new study has found that the brains of older people are better at sorting out useful information versus useless information than those in younger people.

White House Middle Class Task Force Unveils Caregiving Initiative – As part of the federal budget for Fiscal Year 2011, the White House is proposing initiatives to ease the burden for caregivers including $103 million to expand the availability of respite care, counseling, training, referrals, and adult day care.

Genetic Link Found for Parkinson’s Disease – A new study has found that a combination of genetic risks, dietary habits and other environment factors lead to the development of Parkinson’s disease.

Parkinson’s Disease Rehabilitation Center Launched – The American Parkinson’s Disease Association and Boston University have opened the first rehabilitation center aimed specifically for people with Parkinson’s disease.  The center will emphasize exercise, a healthy lifestyle and physical therapy as a way to combat and slow progression of the disease.

Blood Pressure Drug Reduces the Risk of Dementia – A new study has found that people who take drugs to reduce their blood pressure have a 50% lower risk of coming down with dementia.

Caregiver Stress Linked to Hire Risk of Stroke – A new study for the journal Stroke found that caregivers who found the role stressful were 23% more likely to have a stroke.

Assistance to help people pay for the costs of long term care has been included in both the House and Senate healthcare reform packages.  This bill, known as the CLASS Act, establishes a voluntary, affordable government long term care insurance program. 

The coverage is designed to keep people in their own houses and out of institutions like nursing homes whenever possible. Some of the services covered under the CLASS Act include home care, respite care, home modifications, transportation, and assistive technologies.

The premiums will work in a similar manner to life insurance and will vary based on age at the time of purchase.  They are expected to increase periodically with age. 

In order to qualify for benefits, an individual is required to be 18 years old or older and have paid monthly premiums for at least 5 years.  In order to receive coverage, a person must:

• Be unable to perform two or more activities of daily living (ADL) e.g. eating, bathing, dressing, transferring.
• Have a cognitive disability that requires supervision or hands-on assistance such as Alzheimer’s disease, multiple sclerosis or traumatic brain injury.

Senate Passes Healthcare Reform Bill – The US Senate passed a healthcare reform bill on Christmas Eve.  The House of Representatives passed a bill in November.  The two bills will be merged and a final vote is expected by late January.

Alzheimer’s May Lessen the Risk of Getting Cancer – A new study found that people who are suffering from Alzheimer’s are 69 percent less likely to get cancer than people not suffering from the disease.

Nursing Shortage Is A Concern for Baby Boomers – The US is expected to face a nursing shortage just as the baby boom generation begins to retire.  By 2025, the US will be facing a shortfall of 260,000 nurses.

Healthcare Will Need to Change as the Nation Ages – A report from the Institute of Medicine says US is not prepared for the coming boom of senior citizens.  A major concern is a lack of medical professionals, such as geriatricians, to treat aging conditions. 

Happy New Year!  2009 was a big year for eCare Diary.  Since our launch in September, we have seen our daily visitors and registered users increase beyond our expectations and the numbers keep growing each month.  We are so pleased at the response and feedback from the eCare Diary community.  We appreciate the time people have taken to share their thoughts and suggestions. 

We are planning new additions for the site which we will be rolling out over the next few weeks.  Before we go live with them, we will seek your valuable input.  As always, we welcome comments, thoughts and suggestions from our users.  Please share them here.

We hope you have a great 2010!

After months of discussion and negotiation, the US Senate has finished its healthcare reform bill and will be voting on it Christmas Eve.  The US House of Representatives passed its version of healthcare reform in November which means it is likely that a bill will be on President Obama’s desk in early 2010.  This legislation would mark the first major expansion of healthcare coverage in the United States since Medicare and Medicaid were created in 1965.  

I worked on the last healthcare reform effort as a member of the Clinton Healthcare Reform Task Force and Legislative Director to Congressman Eliot Engel (D-NY).  I believe this legislation is important and will be an improvement over our current healthcare system which does not work and cannot be sustained in its current form. 

Helping the Uninsured

There are current 47 million Americans who have no health insurance.  The uninsured are both an economic and social problem.  They are an economic problem because the uninsured raise the cost of health insurance by over $1,000 per year for every family.  Most uninsured people get care through emergency rooms which are required to treat everyone regardless of their ability to pay.  These are hidden costs which are passed along to everyone in the form of higher insurance premiums.

US Senate Set to Pass Healthcare Reform by Christmas – An agreement has been reached in the Senate on a healthcare reform bill and a vote is expected before Christmas.  The bill is expected to be merged with the one passed by the US House of Representatives in the New Year.

Participating in Social Services Activities Can Improve Senior’s Brain Function – A new study has found that volunteer activities such as tutoring students can help improve the brain function of older individuals.

Alzheimer’s Takes A Toll on Finances as Well as Memory – Providing daily care to Alzheimer’s patients including feeding, bathing, and other basic activities is costly and takes a huge toll on the finances of the patient and their families. 

Coffee, Tea May Help Prevent Diabetes – A new Australian study has found that drinking coffee and tea reduce your risk of developing Diabetes Type 2.  The study reports that every cup of coffee you drink reduces the risk of diabetes by 7 percent.

Obesity, Inactivity Are Having a Negative Impact in the Fight Against Heart Disease – New information provided by the American Heart Association finds that medical technology is getting better at treating heart and cardiovascular problems.  However, lack of exercise and obesity are reversing many of the gains being made in medical technology.

Delaying Aging Process May Help Protect Against Alzheimer’s -  A new study has found that slowing the aging process in mice with Alzheimer’s delays the start of the disease.  It has promise to help humans with the disease.

Irregular Arm Swing Maybe A Sign of Parkinson’s Disease – Some neurologists believe irregular arm swings may be an early sign of Parkinson’s.  Early detection of the disease is important for treatment and slowing its progression.

Caregivers Remain Mainly Women – A new study from the National Alliance of Caregiving and AARP found that caregivers remain overwhelmingly women.  The study also found that caregivers are generally employed and spend 19 hours a week caring for a loved one or close friend.

Lowering Medicare Eligibility Age to 55 Proposed As Part of Healthcare Reform – The United States Senate is considering allowing people from ages 55-65 to buy-in to Medicare if they do not have other health insurance.

• Medicare Buy-in for People Ages 55-65 – The Senate bill will lower the age people can sign up for Medicare from 65 to 55 and allow people between 55 and 65 to buy-in to this program if they do not have other insurance.  This would be the largest expansion of Medicare since it began more than 40 years ago.
• Federal Employees Health Program Option – The Senate bill will create a national insurance program mirroring the Federal Employees Health Program where the uninsured could buy health coverage.  It would be run by the federal government but would include only private insurance plans.  The Federal Employees Health Program covers all federal workers including Congress.
• Public Health Insurance Option “Trigger” – Under the Senate proposal, the public health insurance option would only be established if private insurers do not participate in the Federal Employees Health Program described above. 
• Reform of the Insurance Market – The Senate bill will require that insurance companies spend at least 90 cents of every dollar on health care services.  Many insurers currently spend 85 cents or less of every dollar on medical care.

The US House of Representatives has already passed a version of healthcare reform and the Senate is expected to vote on its bill before Christmas.  Once that occurs, the two bills will need to be reconciled and passed again by both houses of Congress before they can be sent to the President for signature.  We will continue to keep the eCare Diary community updated on this important issue as it moves through the legislative process.

Home Health Care Payment Changes Generate Concern – Planned reductions in Medicare home health care payments included in health reform are raising concerns because Medicare patients are the biggest users of these services.  

Smoking Increases the Risk of Colorectal Cancer – A new study shows that long time smokers are at a higher risk of developing colorectal cancer.

Muscle Cell Infusion Shown to Help with Incontinence – A new study has found that cells grown in labs have helped animals intestines shut properly again.  If successful in humans, this treatment could help people suffering from fecal incontinence and acid reflux disease.

Constipation Maybe an Early Sign of Parkinson’s Disease – A study by the Mayo Clinic has found that people suffering from Parkinson’s disease are twice as likely to have a history of constipation than people who do not have the illness.

Understanding Which Vitamins Are Worth the Money – Americans take many vitamin supplements.  However, many people take vitamins they don’t need which not only can cost you money but may not be good for you.

Apathy Common in Patients with Dementia – A recent study has found that apathy is one of the most common psychological problems affecting people with dementia.  More than half of patients suffering from the disease lack motivation and initiative.

Too Much Exercise May Increase Risk for Arthritis – A new study has found that middle aged people who exercise a lot may be putting their knees at risk for Osteoarthritis.

Smoking May Be A Risk Factor In Lou Gehrig’s Disease – Researchers have established that smoking is risk factor in amyotrophic lateral sclerosis (ALS) known as Lou Gehrig’s Disease.

Chronic Pain Linked to Increased Falls Amongst Seniors – More than two thirds of older adults suffer from chronic pain.  A new study has found that this pain is a reason for falls in people over 70 years old.

Baby Boomers Getting More Hip Injuries – Today’s senior citizens are more active than previous generations and doctors are seeing more hip and pelvis injuries because of it.  This trend is expected to continue as the baby boomers begin to retire.

A New Cause for Alzheimer’s May Have Been Discovered – Researchers in Spain have discovered that a precursor to nerve growth factor (pro-NGF) may play a role in Alzheimer’s disease.  High levels of pro-NGF are found in Alzheimer’s patients and this accumulation may lead to natural brain cell death.

Its open enrollment season for Medicare Prescription Drug programs from November 15 to December 31, 2009.  If you are covered by Medicare and are 65 or older, now is the time to choose a plan.

The Medicare prescription drug program is 4 years old.  Yet there is still confusion about how to choose a plan that best fits the needs of you or your loved ones.  I will attempt to clarify some of the questions about this program. 

How Do I Get Prescription Drug Coverage through Medicare

Medicare provides coverage for prescription drugs in both the traditional Medicare plan and in the Medicare Advantage program (Medicare HMOs).  In the traditional program you can go to any doctor who accepts Medicare but must meet a deductible and pay 20% of the costs.  In a Medicare Advantage plan, you pay much lower out of pocket costs but are restricted to doctors who participate in the insurer’s network.  (A future blog will offer more detail about Medicare Advantage plans.)

If you are in a traditional Medicare, you must choose a prescription drug program offered by a private insurer.  If you are in the Medicare Advantage plan you will receive your prescription drug coverage from the Medicare HMO you choose.

If you are 65 and this is the first year you are eligible for this coverage, it is important that you sign up immediately because there is a 1% penalty for every month penalty that you wait.  For example, if you wait a year, you will pay 12% more than the person who signed up immediately. 

What are the Prescription Benefits that Medicare Offers

Medicare requires that all plans provide a minimum level of coverage but many offer better benefits.  In 2010, Medicare requires that plans provide the following:   

New Guidelines Recommend Mammograms at 50, Instead of 40 – The United States Preventive Care Task Force changed the recommended age for starting mammograms every two years from age 40 to age 50.  The new guidelines have created controversy and confusion.

Alzheimer’s Caregivers Overlooked – Advocates for Alzheimer’s caregivers are concerned that policy-makers overlook the unique challenges of caring for these patients.

Surgery in Older People Does Not Cause Memory Problems – For many years it was believed that surgery in older people could be the cause for memory lose.  A new study has found that surgery has no impact on memory in older adults.

An Overactive Immune Response May Be Cause of Viral Infections Amongst Seniors – A study at Yale University has found that exaggerated immune response to viruses may be why senior citizens are more likely to contract viral infections that younger people.

Vitamin D May Impact Multiple Sclerosis – Australian researchers have found that the level of Vitamin D in a person’s system impacts the chances of having a Multiple Sclerosis attack.  The study found the higher the level of Vitamin D, the lower the chance of having an attack.

Allowing My Father to Be Independent While Convincing Him He Needed Help

Parkinson’s is a degenerative disease so when my father was initially diagnosed the medications addressed many of the symptoms permitting him to live independently.  However, as the disease started to take its toll on his body and the medications were less effective, it became harder and harder for him to live without help.  He started to fall, had trouble making meals for himself, dressing himself and bathing himself. 

Medicare Prescription Drug Enrollment Begins - The annual enrollment period for the Medicare Prescription Drug program starts November 15 and ends December 31.  Seniors are encouraged to shop around for the coverage that best fits their needs.

Caregiver Crunch Coming – The aging of the baby boomers, fewer family members and the increasing number of children not living near their parents is going to create a shortage of family caregivers in the near future.

New Law Prohibits Genetic Discrimination – A new law will prohibit employers from requesting genetic tests or considering genetic history in hiring, firings or promotions.  The law also prevents health insurers from requiring genetic tests as a condition of coverage or to set premiums.

Lupus Drug Submitted to FDA for Approval – Experimental Lupus drug Benlysta has completed its first round of testing and is headed to the FDA for approval.  If approved, the medicine could be available by late 2010.

Gene Mutation Is Linked to Parkinson’s Disease – A study in Natural Genetics has found that mutations of the alpha-synuclein gene and microtubule associated protein tau increase the risk of getting Parkinson’s disease.

Editors Note:  In honor of National Family Caregivers Month I will be doing a 3 part series on my caregiving experience.  It will be cross posted at Caregiving.com.

My father was diagnosed with Parkinson’s disease in early 2001 and passed away from it 2 years ago at age 83.  His diagnosis was a life changing experience which resulted in returning to my hometown of New York City from the West Coast and eventually becoming his caregiver.

My father, Ken, started to have hand tremors in 1996, an early symptom of Parkinson’s and a number of other conditions.  He was referred to a neurologist who told him he did not have Parkinson’s but prescribed medication to relieve the trembling.  Incorrect diagnoses of this disease are common because there is no test for Parkinson’s.  Doctors are left to make decisions based solely on symptoms. 

For most of the late 1990s my father lived a full and productive life with few signs that he was suffering from the disease.  In retrospect, there were signs my father had Parkinson’s long before it was properly diagnosed.  He had always had tons of energy yet he started to feel fatigued.  He began to shuffle as he walked and his posture became stooped.  These are all symptoms of Parkinson’s disease.

Healthcare Reform Bill Will Lower Medicare Prescription Drug Costs – The healthcare reform bills being considered in Congress will save $24 billion in the Medicare Prescription Drug program which will be used to close coverage gap known as the "donut hole." 

Parkinson’s Disease May Be Slowed by Antioxidant – A new study found that the progression of Parkinson’s can be determined by the level of the antioxidant urate in serum and cerebral spinal cord fluid. Higher levels of this antioxidant can help slow the disease.

Seniors with Dementia Have a Higher Death Rate from the Flu – Senior citizens who suffer from dementia are 50% more likely to die from the flu than those not suffering from dementia. Part of the reason is these patients have a harder time communicating their symptoms to doctors. 

Diabetics Suffering from Alzheimer’s Have Slower Memory Loss – A French study has found that diabetics with Alzheimer’s have slower memory loss than people suffering from only Alzheimer’s. 

Coffee Can Be Good For Your Health –A Harvard Medical School study has found that coffee can help prevent or slow numerous diseases including cancer, diabetes type 2 and Parkinson’s disease. 

Tai Chi Can Help Arthritis of the Knee – A British study has found the Chinese exercise can help relieve osteoarthritis in the knee. 

Robot Can Help Aging Parents Live Independently – A session at TEDMED, a healthcare technology conference, discussed the use of robots to help care for aging parents at home. This technology could eventually help more people stay in their homes.

My father lost his battle with Parkinson’s disease a little over 2 years ago.  He wasn’t just my father; he was also one of my best friends, so his death hit me very hard.

We would talk almost every day about sports, politics, the world and what was going on in our lives.  To this day, I miss him greatly and think about him daily. 

My grieving period was bittersweet because 3 weeks after my father passed away we learned that my wife, Susan, was pregnant with our first child.  We had been trying to get pregnant for 22 months, and finding out we were bringing another life into the world was truly a cycle of life moment. 

The impending birth of our daughter made the grieving process easier but didn’t make the feelings go away.  I went through most of the 5 Stages of Grief - denial, anger, bargaining, depression, and acceptance.  In the literature on grief, these stages are presented in a linear manner where you go from one stage to the next until you accept what has happened. 

I found my grief to be circular and that not all the stages applied to me.  For example, I was never angry about my father’s death.  He lived until age 83 and had been suffering horribly the last year as the Parkinson’s disease ravaged his body.  While his death was incredibly sad, in some ways it was blessing.  He wasn’t suffering anymore, and he died peacefully with his family surrounding him just as he wished.

Swine Flu Emergency Declared – President Obama declared a swine flu emergency Saturday.  This allows hospitals to move emergency services for swine flu into non-emergency room settings which will help speed treatment and protect non-infected patients.

Swine Flu Hits Children and Young Adults the Hardest – Of the 1,000 people who have died from swine flu, approximately 100 have been children.  It is believe that swine flu is hitting this population harder because their immune systems have not been exposed to as many viruses as older people.

eCareDairy.com blog is starting a new feature today which is the Sunday Caregiver News Roundup. We will review important news stories from the previous week with a quick summary of the article and a link to it.

Swine Vaccine Shortage Predicted – The Centers for Disease Control is predicting a shortage of swine flu vaccine. Only 28-30 million doses will be available instead of the 40 million predicted over the summer. The cause is delays from vaccine manufacturers.

Argument About Swine Flu Vaccinations Continues – Concerns about the safety of the swine flu vaccine has fueled debate whether or not people should get a vaccination.

Study Says Surfing the Web Can Help Slow Dementia – A University of California at Los Angeles (UCLA) study showed increased brain activity for seniors with dementia who spend at least one hour a day on the Internet. It appears that the old adage of use it or lose it is really true.

• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Chills
• Fatigue
• Vomiting (in some cases)
• Diarrhea (in some cases)

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion Severe or persistent vomiting

• Cover your nose and mouth with a tissue when you sneeze or cough. Throw out the tissue after you use it.
• Wash your hands frequently and use a hand sanitizer if you are not in a place where soap and water are readily available.
• Try not to touch you nose and mouth. This is a very common way to spread germs.
• If you are sick or think you are sick, stay home. Sick people coming to work or going to school are one of the most common ways viruses are spread.

• Children under 6 months
• Healthcare and emergency medical services personnel
• Persons between the ages of 6 months and 24 years old
• People ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems.

Earlier in the summer I wrote about President Obama’s support of the late Senator Ted Kennedy’s long term care insurance bill as part of health reform.  While this proposal is an improvement over current programs, it does not provide the comprehensive solution families need to pay for the cost of long term care.

Caring for an elderly or infirm relative is both time consuming and expensive.  According the Department of Health and Human Services, the US spends over $200 billion per year on long term care services.  To give you an idea of what this means to a person receiving care, it costs between $18 and $29 per hour for home health care services and an average of $209 per day for a nursing home. 

Medicare provides only limited coverage for long term care so the US has a piece meal system to cover these services.  The most common ways to pay for care are:

1. Long Term Care Insurance – About 10 million Americans have purchased these policies.  While they help cover the cost of care, they generally cover less than 50% of the expense of long term care. 

2. Medicaid – This program that pays for long term care for people who are poor.  Many people divest themselves of their assets to become eligible for Medicaid coverage.  The rules vary by state.  To learn more about each state’s requirements visit the Financing Care  page of eCareDiary.com.

End of life planning is getting a bad name because of the misinformation being spread about death panels and death books.  This is a shame because end of life planning is important and something we should all be thinking about for ourselves and our loved ones.

End of life planning is about ensuring you are in charge of medical decisions if you become mentally incapacitated and are unable to communicate.  While many people ask that life support be removed if there is no hope of recovery, a living will can require that all life sustaining procedures to be preformed in order to keep you alive.  This is your decision.

I experienced the importance of end of life planning first hand when my father, who had late stage Parkinson’s Disease, suffered a stroke which left him with little brain function.  After the stroke, we learned he had advanced cancer which had not been diagnosed.  While he was able to breath on his own, he was unable to feed himself, drink or perform any bodily functions without assistance. He was totally dependent on others to sustain life.

Fortunately, my father went through end of life planning after being diagnosed with Parkinson’s Disease.  He had a Living Will clearly expressing his wishes, designated a Health Care Proxy to speak on his behalf and established a Power of Attorney for his legal and financial affairs.  Having all this in place removed any doubt about his wishes and eliminated additional stress on the family.

As a caregiver and founder of eCareDiary.com, I am very excited that President Obama has decided to support a long term care benefit in Health Reform.  Based on my past experience in Heath Reform, long term care has rarely come to the forefront of the healthcare discussion, so this is a welcome development.

Senator Ted Kennedy has proposed a federal long term care insurance program which is included in the Health Reform bill. The Kennedy proposal would create an affordable long term care insurance policy that working individuals could purchase for as little as $65 per month.  This is a low premium considering an average long term care insurance policy for a 55 year old will cost over $100 month and will increase to over $300 for a senior citizen.  (For more information, here is the link to the bill)

The long term care insurance program would provide a benefit of $50 per day for home care and nursing home services.  While this is a modest amount, it will help many people stay in their homes when they become debilitated with long term illnesses.

One of the toughest conversations a caregiver has to hold is telling a loved one they need help caring for themselves.  I faced this discussion about 4 years with my father who was suffering from Parkinson’s disease at the time.

The process of determining the long term care needs of your loved one, breaking the news to them that they need help and setting up the services should be deliberate and done with care.  It is important that you provide the care recipient with the help they need without breaking their spirit.  I have outlined some tips to help you deal with this difficult process.

1. Can the Patient Perform Activities of Daily Living (ADLs)? – Activities of Daily Living are the self care actions we perform for ourselves everyday and include bathing, dressing, undressing, cooking, eating, walking, using the toilet and getting in and out of a chair or bed.  If you notice that your loved one has a problem performing one or more of these ADLs then he or she needs some form of long term care.   

2. Begin the Conversation Early– Chances are you will need to have multiple conversations with your loved one before they will agree to receive long term care so begin the conversation as soon as you notice they are having problems.  Remember the person you are setting up care for has been caring for themselves for most of their life so the idea of receiving long term care is going to be frustrating, frightening and humiliating.  It is important to be sensitive to their needs and feelings as you discuss the situation.