What is Hospice? Crossroads Frequently Asked Questions #avalon #hospice

#hospice questions

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Frequently asked questions

There are many questions. and myths. about hospice. Below are answers to some the most common questions asked. They will give you get a better understanding of what hospice care is and how it can benefit your family.

Have more questions about hospice care? Please contact us now.

  • What is hospice care?
  • Is hospice only for people who are dying?
  • Who is best suited for hospice care?
  • Isn t using hospice the same as giving up ?
  • Should we wait for the doctor to suggest hospice?
  • When is the best time to start hospice care?
  • Who pays for hospice care?
  • Once you begin hospice care, you cannot leave the program?
  • Is hospice a place?
  • Does hospice only care for cancer patients?
  • Is hospice only for housebound or bed-ridden people?
  • Hospice “dopes people up” so they become addicted or sleep all the time?
  • What is hospice care?

    Hospice is a philosophy of care. It treats the person rather than the disease and focuses on quality of life. It surrounds the patient and family with a team consisting of professionals who not only address physical distress, but emotional and spiritual issues as well. Hospice care is patient-centered because the needs of the patient and family drive the activities of the hospice team .

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  • Is hospice only for people who are dying?

    Hospice is for people who have a limited life expectancy. (Actually, we all have a limited life expectancy, so it is more specific than that.) Hospice is for patients whose condition is such that a doctor would not be surprised if the patient died within the next six months. This doesn’t mean the patient is going to die in the next six months–it simply means that he or she has a condition that makes dying a realistic possibility.

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  • Who is best suited for hospice care?

    Hospice patients are those with very serious medical conditions. Usually they have diseases that are life threatening and make day-to-day living very uncomfortable—physically, emotionally, or spiritually. Some are in pain. Others experience difficult symptoms such as nausea, extreme fatigue, and shortness of breath. These symptoms may be caused by the disease, or they may have been caused by treatments intended to cure the disease. Often patients turn to hospice because they are anxious or depressed, or they are feeling spiritually distressed because of their medical condition. Hospice specializes in easing pain, discomfort, and distress on all levels. The care provided by hospice is often helpful for conditions such as cancer, heart disease, COPD (emphysema) and advanced dementia. Seriously ill patients who have decided that their priority is to have the best quality of life possible are the people who are best suited for hospice.

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  • Isn t using hospice the same as giving up ?

    Not at all! This is one of the most common questions about hospice but it is actually a misconception. Although your loved one’s condition may have reached a point that a cure is not likely—or not likely enough to be worth the side effects of treatment—that does not mean there is nothing left to do. In fact, an emphasis on quality of life and easing pain and distress often allows the patient to spend his or her last months focusing on the things that are ultimately the most important and meaningful. As one man put it, “I’d rather spend my time with my children and grandchildren than waste my limited time and energy driving to the treatment center and recovering beside the toilet bowl.” With the expert guidance of a nurse and case manager, as well as the assistance of bath aides, social workers, and chaplains, patients and families find they can focus on their relationships, healing old wounds and building wonderful memories together. Far from giving up, hospice helps families truly live well and support each other during a stressful, but, in the end, very natural family life passage.

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  • Should we wait for the doctor to suggest hospice?

    You can, but oddly enough, doctors often wait for families to bring it up. This is part of the reason that people often receive hospice care so late in the process. If you think your loved one and family might benefit from the support of weekly home visits from staff who specialize in pain control and the easing of distress, ask your doctor if hospice might be something to consider now, or in the near future. If, when you are truly honest with yourself, you realize that you would not be surprised if your loved one were to die in the next six to twelve months, ask the doctor if he or she would be surprised. If the answer is anything close to “No, I would not be surprised,” then maybe it’s a good time to begin a discussion about hospice. If you would like more information, please feel free to call us toll-free 1-888-603-MORE (6673). We would be happy to talk with you or to do an informational home visit—no obligation or strings attached.

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  • When is the best time to start hospice care?

    Most patients and families who receive hospice care say they wish they had known about it earlier, that they needed the help much sooner than they received it. Research has shown that hospice can increase both the quality of life and how long a patient lives. Families who receive hospice near the very end–just a few days to a week–have been shown to have a harder time adjusting during the bereavement period than do those whose loved one receives hospice care for weeks and months before passing on. If you even think that your family and the person you care for could benefit from pain or symptom management, assistance with bathing and grooming, emotional and spiritual support, and telephone access to caregiving advice, ask your physician if hospice might be a service to consider. Experts agree that at least two to three months of care is optimal. It is better to ask sooner rather than later so you do not regret having missed the support that hospice has to offer.

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  • Who pays for hospice care?

    Patients have several options when it comes to paying for the cost of hospice care. If the patient has Medicare and meets hospice eligibility requirements, then the government will pay as much as 100% of the cost. In such a case, there is no deductible and no copayment. Not only are the services of the hospice staff entirely covered, but medical supplies and prescriptions relating to pain and comfort management are also covered. Individuals who do not have Medicare coverage but have coverage from private insurance should talk with their insurance company to find out about eligibility and what deductibles and copayments may apply. Medicaid provides coverage, but it varies by state.

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  • Once you begin hospice care, you cannot leave the program?

    A person may sign out of the hospice program for a variety of reasons, such as resuming aggressive curative treatment or pursuing experimental measures. Or, if a patient shows signs of recovery and no longer meets the 6 month guideline, he or she can be discharged from hospice care and return to the program when the illness has progressed at a later time.

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  • Is hospice a place?

    Hospice is not just a place – it’s a service. Hospice brings physical, emotional, and spiritual care and support to wherever our patients call home.

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  • Does hospice only care for cancer patients?

    Hospice is not just for cancer patients. Crossroads Hospice cares for patients with any life-limiting illness. Among the illnesses our patients have had are cardiac and respiratory diseases, renal disease, and neurological illness including Alzheimer’s disease, Lou Gehrig’s disease, AIDS, Cirrhosis, and others.

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  • Is hospice only for housebound or bed-ridden people?

    Hospice is not only for those who are housebound or bedridden; most are living their day-to-day lives. Care is given where ever the patient lives; in their home, long-term care facilities, assisted living or retirement communities, rest homes and hospitals.

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  • Hospice “dopes people up” so they become addicted or sleep all the time?

    When patients have a legitimate need for pain medication, they do not become addicted to it. Crossroads Hospice has the expertise to manage pain so that patients are comfortable yet alert and are able to enjoy each day to the fullest extent possible, given their medical condition.





FAQ: What might I expect to happen when someone I – m caring for is dying? #franconia #notch #motel

#hospice dying process

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This is a difficult topic for many people to think about, and especially to bring up in a public forum, but people still want and need to know what they might expect as they or someone they care for are declining. It is understandable to fear the unknown, and to fear suffering. I would say that there are a few leading points here:

1) Most patients don t suffer much as their cancer progresses and as they transition through the dying process.

2) This process is quite variable from one person to another, but we typically have a good idea of what a patient s leading problems will be weeks to months before a person is experiencing a more rapid decline.

3) Engaging hospice services/palliative care can help guide expectations and generally manage many of the problems effectively by anticipating them, rather than waiting until very late to accept palliative care.

While I would never want to romanticize or minimize the challenges of the dying process, I find that the majority of my patients experience a controlled decline in which they really don t suffer. The most common pattern I see is that someone with a progressing cancer will slow down, eat less, begin to lose weight more steadily, and just gradually become less and less active. They no longer go out on walks, then leave the house less often, then spend more time alternating between sleeping and getting up in a chair, then eventually get to a point where they are sleeping most of the time and are pretty much bed-bound. They have less interest in eating, which is sometimes frustrating to the patient but often more so to the family and supporters of the person, who may pressure the patient to force down food that they have little or no appetite for (the danger is that some patients describe distress from the unyielding pressure from well-intentioned but nagging loved ones). Soon, they are sleeping more and more, to the point that they eventually sleep all of the time and are no longer communicative; this is followed by irregular breathing, more prolonged pauses between breaths (called agonal breathing, though it isn t uncomfortable for the person, just a reflex the last phase of the dying process), and then they stop breathing. It s important to remember that this common pathway of progression isn t a lack of will on the part of the person with progressing cancer: they would eat and be more active if they could, but the cancer pours out toxic proteins that mediate this inexorable process.

It s true that some patients have pain, or a terrible cough, or shortness of breath, agitation, and other problems, but I would say that most of the time, we have signals that these are going to be issues for a long while before the later stages, and it s advisable to deal with them as aggressively as possible before these symptoms become a crisis. Secondly, I most commonly see problems emerge when people (patients and/or their doctors) are very resistant to enlisting hospice support, which typically does a very good job of addressing symptoms proactively, before they become a crisis, and also being able to provide the comfort of helping patients and families/caregivers to understand what to expect in the near future. Just as on a plane, turbulence is much easier to understand if you know to expect it, what it represents, and how you ll get through it.

About 20 years ago, I spent some time in medical school doing home visits with the very compassionate and thoughtful Medical Director of a Boston hospice. I asked him about his feelings on euthanasia, and he told me that he didn t actually feel that it was a pressing need in almost any cases. Specifically, he noted that it was most common for people to fear two things about dying: being alone in being in pain. Though being a primary caregiver is a very hard job, it is a great blessing to have someone there to help as a caregiver to a terminally ill patient something that even attentive medical care can t substitute for. That care and the ability to ensure that people aren t alone is incredibly helpful. But a medical team today can usually do a good job to minimize the physical suffering of the process to relieve pain and other symptoms. And most of the time, what we see is a patient gradually withdrawing and eventually passing comfortably.

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Hospice care and palliative care: What – s the difference? #benefits #of #hospice #care

#palliative care versus hospice

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Hospice care and palliative care: What s the difference?

I’ve talked to hundreds of people about the health care options and decisions they face at the end of life. It’s a challenging time and understandably many have little knowledge, while others have misconceptions, and some have bitter disagreements.

Here’s a basic primer for two common approaches: hospice and palliative care.

Two myths about hospice care are prevalent. First, many people believe hospice is provided in a place like a hospital. While it’s true many hospices have residential facilities, hospice care is usually given at home.

Second, people often believe that with hospice, there is no treatment but pain control. That’s not the case at all. Medical care will continue as before, except that further attempts to cure the major disease will stop. If a person gets a bladder infection, or pneumonia, for example, regular treatment will be available. If the person chooses to not go to a hospital for treatment of something like pneumonia, treatment at home will be offered. And if a breakthrough cure of the primary disease occurs, it will not be denied to the hospice patient.

Often I am the first one to bring up hospice care with the patient or their family. As geriatricians, my colleagues and I see many people with incurable and late stage disease. (It’s important to know that hospice care is available for all ages, though.) For patients and families, electing hospice care means extra help for the family, and occasionally the provision of helpful equipment. We bring up hospice care when we believe the patient or family will benefit from these extra services.

Sometimes it’s a touchy subject. I’ve been angrily yelled at by family who want the patient to keep trying for cure, to keep taking chemotherapy, to try more radiation, to go for more surgery or to some other country for some unproven therapy. We frequently think these family members are either uninformed or in denial. We sometimes wish they could feel their loved one’s nausea, weakness and confusion from hopeless chemotherapy, or their desperate struggle for air in advanced lung disease.

Sometimes the cost of hospice is a concern. Medicare and most insurance companies cover hospice care. Hospice is covered under Medicare Part A. There is no deductible, and copayments are very low. The restriction is that care must be coordinated by the hospice team.

Hospice care is defined fairly clearly by Medicare and other insurers. “Palliative care” seems more ambiguous – there is no standard definition – and is often less understood than hospice care. Palliative care is focused on making patients as comfortable as possible with an emphasis on maximizing the quality of daily life. It is provided in different ways. In our Palliative Care Consult Service, we provide suggestions to the regular treating physician and to the family, usually about pain and other symptoms. Our consult service often includes a social worker and a faith community representative.

Bitter disagreements about end of life care come not only from family members but also from providers. About 15 years ago, when I was with the National Institute on Aging, I had a discussion with an oncologist who represented a professional society. He argued that there should be no limit on chemotherapy, up to the point of death. We discussed a new therapy that would add one month of life expectancy to a geriatric patient. His position was that regardless of the intense side effects it caused, it should be prescribed and encouraged. My position was it should be discussed with the patient, and if it is declined, that decision should be respected. Now years later, that controversy persists, not just among oncologists. Terminal care is also provided by pulmonologists, cardiologists, and generalists, for example, some of whom advocate intensive care to the end, while others respect the patient’s request for limited care.

This basic primer is like a map. “There is North America, and there is Europe.” They are separated by an ocean, yet they have much in common. North America is like hospice, with clear boundaries. Palliative care may be more like Europe, which merges into Asia (which may be like “usual care”). Where one stops and the other begins is mostly a political decision, just like the separation of palliative vs. usual care.

End of life care can be challenging, and the options may seem murky. In order to find their way, patients, family members and physicians might benefit from “GPS” systems, including helpful road side assistance to help them navigate these complex health care decisions. Definitions and primers are just the start of customizing this final journey.

James Cooper is Clinical Professor of Medicine, Division of Geriatrics and Palliative Care, George Washington University. He blogs on the Prepared Patient Forum .

I apologize, but I m still a bit confused about the difference. Are the two types of care mutually exclusive? Or would hospices provide palliative care in addition to other services? If the latter, what additional services would a hospice provide?

Or, if palliative care is just focused on alleviating symptoms, is it appropriate for people not facing the end of their lives?

There are differences in the benefits you get with hospice vs palliative care. With hospice, the patient can receive help with home care (shopping, cleaning, laundry, etc.) without a skilled nursing need. With palliative care, that s not available unless there s a skilled nursing need (wound care, dressing changes, osteomy care, PT, OT, etc.) With hospice a physician must certify that in his/her opinion the life expectancy likely won t exceed 6 months (though there can be extensions). So, yes, hospice care does provide palliative care in addition to other services. The hospice approach is holistic and team based (as is palliative care). And home hospice refers to all of these services provided in the patient s home.

Do you think that hospice care has resulted from the futility of certain medical treatments? do you believe that hospice care offers a non- medicalized dying process? Under what conditions would hospice care merge with paliative care? Do you think that the crucial factor would be the state of disease of the patient? What if the person is merely physically disabled?

After almost 40 years as a respiratory therapist it has been my experience and those of many of my coworkers that the vast majority of family members are acting because of their own needs-frequently guilt or money. They think about how they feel, not how the patient feels. Even what the patient has specifically filled out a DNR order their family overrides it and the patient is subjected to days, weeks and sometimes even months of painful procedures that does not prolong life, it only prolongs death. Whoever wrote Americans think death is optional was so right

Leslie, I believe fear is the biggest factor as many people want to do something to help and change the situation or turn the clock back. The hospice team can help to manage the difficulties that families have. While many make decisions that are in line with what they want, we can t fault them for the suffering that they are enduring while witnessing the decline and loss of someone in their lives. The navigating of the dynamics that help the loved ones are the true skills of the hospice team in addition to the relief of suffering through good pain and symptom management.

I agree that people don t want this situation. I also agree that hospice people are wonderful and incredibly strong to do the stressful work that they do every day. I had hospice for my mother. I think that the physicians need to be more proactive in suggesting hospice. I think they need to eliminate the ideas that keeping a patient a full code will change the outcome. I m not saying that it is not difficult. I m saying that frequently it is difficult for the wrong reasons.





What does a Palliative Care Nurse do? (with pictures) – mobile wiseGEEK #heathrow #airport #hotels

#palliative nurse

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wiseGEEK: What does a Palliative Care Nurse do?

A palliative care nurse is a health care professional who provides treatment and counsel to patients who are dying of incurable illnesses. Nurses work with physicians and other medical professionals to diagnose, treat, and care for individuals with progressive terminal conditions. They help patients and their family members cope with very difficult circumstances by providing information, counseling, and support. An experienced palliative care nurse may also conduct research about terminal diseases and advanced care practices, develop new policies regarding patient care, advocate public awareness, and teach nursing courses at hospitals and colleges.

Patients who are diagnosed with incurable diseases often struggle to find the strength and hope to enjoy their last moments. It is the duty of a palliative care nurse to ensure that such patients receive the best possible treatments to relieve their pain and symptoms. Professionals often become close companions with their patients, providing counsel, empathy, and friendship when they need it the most. The nature of the job can be very physically and emotionally demanding, and nurses must be capable of dealing with loss and tragedy on a regular basis.

Besides administering direct care to patients, palliative care nurses frequently meet with friends and family members to help them cope with the situation and discuss the options for end-of-life treatment. Many nurses engage in research to develop new public policies and determine the best methods for administering palliative care. Professionals often take part in hospital or community discussions to present their findings and suggest ways to improve procedures.

A prospective palliative care nurse is usually required to complete a four-year bachelor’s degree program in nursing as well as a two-year master’s program to gain nurse practitioner credentials. Most new nurses intern for at least one year in an emergency room or hospital setting to gain practical experience and prepare for their eventual careers in palliative care. Individuals are usually required to pass extensive written examinations administered by a nationally recognized organization to become certified palliative care nurses. In the United States, certification is available through the Hospice and Palliative Nurses Association (HPNA). Most other countries rely on organizations similar to the HPNA to ensure that individuals are sufficiently prepared for the job.

Most palliative care nurses work about 40 hours a week, though their schedules are rarely regular. The times and days a palliative care nurse works depends on the condition of his or her patients. A nurse may be required to work weekend, overnight, or double shifts when a patient nears the end of life in order to provide constant care. Many nurses continue to meet with family members after the passing of a loved one in order to provide encouragement and emotional support.

Article Discussion

4) I’m thinking of studying to be a palliative care nurse. I have been researching a lot about what the job involves and I’m not sure if it may be too emotional?

I’m a senior care assistant at present and have to deal with supporting individuals and families with death so I have a slight understanding of what the job would involve.

My only worry is be that I have a young child and am thinking about having another one. I know the training takes years to complete but if the job is going to effect my children then perhaps the job isn’t for me.

Any comments or suggestions for me would be welcome.

3) My grandmother lived with a terminal illness for many years, and I bless the nurse who provided this service for her. I don’t know what exactly is written in a nurses job description, but she went above and beyond, and made my gran truly live her last years to the fullest.

The job is not easy, but it’s mostly more emotionally draining than depressing. It isn’t something that you really want to come home and talk about though. This is partly out of respect for your patient, partly to shield your partner from endless tales of lives ending.

Part of my nurse education in this field covered the need for a neutral person to be sought out and be there for you to offload onto. I know I will have this structured into my week, but the person who provides this outlet is a counselor.

It sounds as if your girlfriend may not have this option, or may not be using it. She could also be burning out, and need to take a break. You could try talking to her about her feelings, and suggest she needs someone to talk to. Hope it works out for you.

1) I’ve recently started dating a wonderful woman who is a palliative care nurse practitioner. Even though it’s early days in our relationship I can see it becoming more serious. The problem is that I don’t know how best to support her.

There’s no issue for me if she has to work long hours or cancel dates because of work. I know a job in nursing isn’t ever going to be about working social hours. I guess I’m struggling with the emotional side of it.

She seems unwilling to talk about work and let her feelings out, so more and more we’re spending time in silence. I have no idea what to say and her mind seems to be elsewhere. Should I push her to speak to me?





QAPI – What does QAPI stand for? The Free Dictionary #hatta #fort #hotel

#qapi hospice

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References in periodicals archive ?

The facility was recently awarded with QAPI Accreditation which requires the facility to be successful in three of these four categories: Comprehensive, Continuous, Coverage and Corrective QAPI .

Clear, complete and accurate nursing documentation communicates important information to others, allows for continuity of quality care, facilitates QAPI initiatives, and bolsters risk management.

Getting to the root of the problem is an essential part of QAPI .

The Centers for Medicare Medicaid Services (CMS) is responsible for both promulgating the QAPI regulation and providing technical assistance to NHs.

At the end of its section on QAPI. CMS states: “We believe these requirements are the single most important provision in this proposed rule to fulfill the congressional mandate for process performance measures based on empirical evidence of organ donor potential and other related factors in OPO service areas.

We believe that QAPI is regarded by the health care community as the most efficient and effective method for improving quality and performance of health care providers,” CMS stated.

QAPI at a Glance is the Centers for Medicare Medicaid Services’ implementation guidebook.

Engage the QAPI or Quality Assurance committee and compliance committee (both committees, being required, should be in place).

Quality Assessment Performance Improvement – IFMC will complete seven QAPI projects each year.

This analogy spotlights the fifth step of the 12 Quality Assurance Performance Improvement ( QAPI ) implementation steps–Develop Your QAPI Plan.

The third of the 12 QAPI implementation steps is “Take your QAPI ‘Pulse’ with a Self-Assessment.

QAPI is a comprehensive approach to ensuring high-quality, proactive, patient-centered care using evidence-based practices to increase knowledge for planning, implementing and sustaining measurable improvement.





What Is Terminal Illness? #motel #santa #cruz

#what is a terminal illness

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What is Terminal Illness?

What is terminal illness; what do the words actually mean? It is a topic frequently brought up in the media, but what is the definition?

Simply put, a terminal illness is an infection or an illness which will result in death. Terminal illnesses or infections are considered incurable when there are no conservative therapies available which will eliminate it from the body. This medical phrase is usually used when there is a life expectancy of six months or less and complimentary and alternative medicine (CAM) options are not included when referring to “treatments.”

It is possible to be diagnosed with a “terminal illness” and outlive the six-month life expectancy. Examples of illnesses and infections which could have relatively long life-spans are: Acquired Immunodeficiency Syndrome (AIDS) and neurological illness such as Alzheimer’s, and Parkinson’s.

Now, knowing what is terminal illness, you may be wondering “are there any treatment options”?

Return to Terminal Illness

HOME from What Is Terminal Illness

Continue to Treatment Options

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What does palliative mean? definition, meaning and pronunciation (Free English Language Dictionary) #supportive #care

#what does palliative care mean

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PALLIATIVE

Dictionary entry overview: What does palliative mean?

PALLIATIVE (noun)
The noun PALLIATIVE has 1 sense:

1. remedy that alleviates pain without curing

Familiarity information: PALLIATIVE used as a noun is very rare.

PALLIATIVE (adjective)
The adjective PALLIATIVE has 1 sense:

1. moderating pain or sorrow by making it easier to bear

Familiarity information: PALLIATIVE used as an adjective is very rare.

Dictionary entry details

PALLIATIVE (noun)

palliative [BACK TO TOP]

Remedy that alleviates pain without curing

Nouns denoting man-made objects

Hypernyms ( palliative is a kind of. ):

PALLIATIVE (adjective)

palliative [BACK TO TOP]

Moderating pain or sorrow by making it easier to bear

moderating (lessening in intensity or strength)

Learn English with. Proverbs of the week

Beer before liquor, you’ll never be sicker, but liquor before beer and you’re in the clear. (English proverb)

Complete idiot who can keep silent, to a wise man is similar (Breton proverb)

The arrogant army will lose the battle for sure. (Chinese proverb)

Where there’s a will, there is a way. (Dutch proverb)

PALLIATIVE: related words searches

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What is Private Duty Home Care? #hospice #atlanta #center

#private duty nursing

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What is Private Duty Home Care?

Published: Feb 25, 2014

What is Private Duty Home Care?

In-home care is one of the greatest long-term needs for seniors with chronic illness or for those who are unable to attend to themselves. Private duty home care is one option that may fit your loved one’s needs. This type of home care can come from an agency or you may hire a private caregiver. The question is: What is private duty home care?

Private duty home care is just a sub-set of general home care. Caregivers can provide a broad range of services. from medical and nursing care to bill paying and transportation services. Their goal is to provide whatever the senior and their family needs in order for them to remain independent in their own homes. Some services provided by private duty home caregivers are:

  • Personal care – bathing / dressing, hygiene, transfers, and ambulation
  • Homemakers / companions
  • Meal preparation
  • Medication reminders
  • Caregivers trained for clients with specialized conditions such as Alzheimer’s Disease, hospice, end of life or other needs
  • Transportation for shopping, doctor’s visits or other needs

Private duty home care may differ from traditional home care because of the payment method. Also known as insurance-paid in-home services, there are usually two types of approaches for payment:

  1. Full coverage medical insurance where the insurance company pays the claims for their customers
  2. Medicare supplemental insurance where a medical insurance policy either supplements the customer’s Medicare insurance or takes the place of Medicare insurance

With private duty paid in-home services, some patients pay for in-home services out of their own pocket, or from a long term care insurance policy. Additionally, there are a number of hybrid forms of payment methods including various combinations of the commonly used insurance, Medicare, Medicaid and private duty. Private duty home care is a great way for your loved one to stay independent and receive professional care. Being looked after by a professional also inserts a new companion in your loved one’s life.

So now when someone asks, “What is private duty home care?” you can confidently provide an answer. For more information on what private duty home care includes, visit the Private Duty Home Care Association website, or contact a Comfort Keepers representative to help you find a location offering these services near you.





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MongoDB is the leading NoSQL database, empowering businesses to be more agile and scalable.

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    Looking for an experienced #meanio developer, with leading capabilities, for a project in Lyon, France. Contact us. OL, Les Champions!

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  • A Trusted Payroll Company in Houston #what #is #a #payroll #company


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    Aloha The Payroll Company


    Aloha, I’m Tom Rathjen. I’ve been providing payroll services to my CPA clients for more than 10 years. Together with my wife, Nicole, we started Aloha Payroll to expand our payroll offering and provide outstanding service. We are located in Texas but Nicole is from Hawaii, which explains our name!

    We’ve seen a lot of changes in HR and payroll over the last decade alone. The Internet, electronic devices and software advances created opportunities for time savings, making our lives easier and more productive. But payroll became more complex and technology was slow to catch up.

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    Aloha Payroll provides payroll services to a wide range of companies in the Houston area. We understand that different industries have different needs when it comes to payroll and timekeeping. From retail stores and medical providers, to law firms, restaurants and everything in between – Aloha Payroll will customize a modern payroll solution perfect for you!

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    What is Human Resource Development? #human #resource #master #degree, #what #is #human #resource #development?


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    What Is Human Resource Development?

    Find out about the field of human resource development (HRD). Learn about jobs, education requirements and degree programs, as well as the career outlook for HRD professionals. Schools offering Accounting & Human Resources degrees can also be found in these popular choices.

    Essential Information

    Human resource development (HRD), or employee development, is the process of training and mentoring employees to increase their knowledge, skills and abilities. HRD professionals typically work in human resource offices and plan and administer HRD programs. HRD often includes technology, language and leadership training classes. Some companies also encourage their employees to complete degrees by supplying funding and incentives through their HRD program.

    Important Facts About Human Resource Development

    Instructional, interpersonal, analytical, listening, and speaking skills

    Typically working with people and giving presentations full-time during regular business hours, sometimes traveling

    Offered through the American Society for Training and Development and the International Society for Performance Improvement

    Instructional Coordinator, School/Career Counselor, Labor Relations Specialist

    Jobs in Human Resource Development

    Jobs in HRD include both trainers and managers. Training and development specialists assess the needs of businesses and organizations, determine what training programs are needed and conduct the training. These workers typically need a bachelor’s degree and some experience in teaching or training. Training and development managers oversee HRD specialists and programs. They determine the HRD budget and sometimes instruct specialists in training techniques. Managers in this field need a bachelor’s degree, but many have master’s degrees, and all need experience in the field. Many managers begin their career as training specialists.

    Education Programs

    Many colleges and universities offer degrees in human resource development. The majority offer master’s degrees. Some master’s degree programs focus on preparing graduates to teach human resource development. Others focus on preparing graduates to apply what they’ve learned in organizational settings. Many of these programs are directed towards working professionals and offer part-time and online options.

    Career Information

    According to the U.S. Bureau of Labor Statistics (BLS), jobs for training and development specialists are expected to grow at a slightly faster-than-average rate of 15% from 2012 to 2022. Employment of training and development managers is expected to grow at an about-average rate of 11% during the same period. In 2014, the BLS reported that specialists earned a median annual salary of $57,340, while managers earned a median of $101,930.

    To continue researching, browse degree options below for course curriculum, prerequisites and financial aid information. Or, learn more about the subject by reading the related articles below:



    What We Do #24 #hour #hospice #care

    #what do hospices do

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    What We Do

    Hospice is a vital part of the continuum of care that is available to seriously ill patients and their families. Neither hastening nor postponing dying, Hospice strives to bring quality of life and comfort to patients. Just as doctors and midwives lend support and expertise during childbirth, Hospice provides care and knowledge during the dying process.

    Hospice Community Care provides comprehensive management of physical, emotional, social and spiritual needs of patients. The goal of care is to achieve the best possible quality of life through relief of suffering, control of symptoms and restoration of function capacity.

    Our History

    Locally, hospice care began in 1985 due to the efforts of community leaders in response to one woman’s struggle with cancer and her desire to remain at home until her death. Hospice Community Care has seen similar stories played out over our 20 year history having served thousands of patients and their families. Today, Hospice Community Care serves residents of a six county area including York, Chester, Lancaster Cherokee, Fairfield and Union counties in South Carolina. Governed by a volunteer Board of Directors, Hospice Community Care currently utilizes a vast team of professional staff and over 250 community volunteers to compassionately care for more than 100 patients each day. In 2008 Hospice Community Care moved on the Hospice Community Care campus in Rock Hill which houses the Community Building and the Wayne T. Patrick Hospice House.

    Mission, Vision, Values

    Through an interdisciplinary, medically directed team of professionals and volunteers physical, social, emotional and spiritual support is provided to patients and their families. The care is expressly tailored to each patient’s needs and wishes and is focused on treating the person, not the disease. Teams include a physician, registered nurses, social workers, certified nursing assistants, grief counselors, clergy and volunteers. Hospice Community Care also provides a broad range of programs, educational seminars and counseling opportunities to help hospice families and the community cope with grief and loss.

    Mission

    The mission of Hospice Community Care is to give hope, comfort and compassion to our community when needed most.

    Vision

    Our vision for the future is to remain the area’s first and best choice in the services that we provide.

    Values

    Our shared values of integrity, stewardship, compassion, quality, teamwork and innovation guide our organization and form the foundation of who we are and what we believe.

    Our Leadership

    Hospice Community Care is led by a volunteer board of directors, representative of our community and those we serve. We recognize the trust you have placed in us and pledge to uphold the mission of Hospice Community Care and to be faithful stewards of the resources so generously shared with us.

    Jane Armstrong, RN MN Executive Director

    Meet our Executive Director

    Jane Armstrong has been the Executive Director of Hospice Community Care since 1998. Under her leadership, Hospice Community Care has grown from a small group of volunteers and staff into the leading not-for-profit community-based hospice in the area. Hospice Community Care employs more than 90 people and cares for hundreds of patients and families each year in our community. Under Jane’s leadership Hospice Community Care has become known for its innovation and dedication to moving forward the mission of the organization. At the end of 2007 Hospice Community Care moved onto its new $12 million campus which houses the Wayne T. Patrick Hospice House. The move represented the completion of 10 years of planning and fundraising by Jane, Hospice staff and the Hospice Community Care Board of Directors.

    Board of Directors

    Kathy Patrick Wilson – President

    Kyle Curtis- Vice President

    Anne Weeks – Secretary

    Harvey Heise – Treasurer





    What is Perinatal Hospice? #last #minute #room #deals

    #perinatal hospice

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    Focus on the Family

    What is Perinatal Hospice?

    Perinatal hospice is designed for parents who have received a devastating prenatal diagnosis and elect to continue the pregnancy despite the likelihood that their baby will die before or after birth. Simply stated, the perinatal hospice team comes alongside the family as they make meaningful plans to honor and celebrate the life of their baby, compassionately providing the clear and relevant information they need, such as:

    Practical Guidance

    • Assist with the creation of a personalized birth plan that speaks to parents’ wishes for the labor and delivery experience and care of their baby at birth.
    • Provide coordination of services between different caregivers.
    • Assist the family with the collection and preservation of keepsakes.
    • Help the family plan a memorial service.

    Educational Support

    • Provide parents with specific information about their baby’s diagnosis.
    • Help parents as well as other family members know what to expect throughout the grieving process.
    • Offer private childbirth education classes and hospital tours.

    Emotional Support

    • Provide grief support beginning at time of diagnosis.
    • Offer referrals for pastoral care as requested.
    • Attend delivery at the family’s request to serve as an advocate and to provide additional emotional support.
    • Provide follow-up support throughout the bereavement period.
    • Refer parents to a local perinatal bereavement support group.

    Copyright © 2010 Focus on the Family. All rights reserved.





    Renter’s Insurance 101 #renter #insurance, #tenant #insurance, #tenant #insurance #ontario, #how #much #is #tenant #insurance, #rental #property #insurance, #how #much #is #renters #insurance, #what #is #tenant #insurance, #tenant #insurance #cost #


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    Home Insurance
    Article

    Renter’s Insurance 101

    According to Statistics Canada, less than half of renters in Canada have renter’s insurance 1 (also known as tenant or contents insurance).

    We often think of home insurance as protecting the big stuff—like pipes, appliances, and the physical structure of the home or building. If you are renting, your landlord may have his or her own insurance policy to cover these kinds of items. But their insurance will not cover your personal belongings, such as furniture, jewellery, or entertainment equipment. Your landlord’s insurance will also not protect you if someone is injured on your property.

    That’s where renter’s insurance comes in. Renter’s insurance will help you replace these possessions in the event of a loss or damage due to a covered risk. Speak to an Advisor to see how we can tailor your insurance to fit your needs.

    Let’s start by understanding the importance of liability insurance.

    Accidents happen and sometimes those accidents can be quite costly.

    For example, a candle in your apartment could cause a fire. If that candle affects other units, you may be deemed responsible to pay for damages to your rental unit.

    Or, if someone trips and falls in your apartment, you could be held financially responsible for the cost of medical expenses and lost wages.

    Liability insurance could protect you in the event of a lawsuit, and help you cover the cost of any damages.

    Next you need to understand a few basic terms:

    • All-Risk insures your building and contents for losses due to the widest range of perils (or risks), unless specifically excluded from your policy like intentional damage
    • Personal Liability insurance protects you for unintentionally injuring someone or damaging their property and have to pay damages (example: someone has a slip and fall on your walkway, breaks his/her leg and now cannot work for a period of time)
    • Contents Insurance covers your belongings (including when you travel) for losses resulting from the most common types of perils (or risks) up to a specified amount
    • Replacement Cost Coverage means that the contents of your home are insured for the amount it costs to replace them without depreciation
    • Additional Living Expenses Coverage will help you pay for reasonable and necessary expenses (like hotel and food costs) in the situation you are forced to leave your home following an insured peril (or risk) for a period of time

    Find the home insurance coverage that best fits your needs

    1 Most renters skip home insurance. (2010, January 19). CBC News. Retrieved January 20, 2016, from http://www.cbc.ca/news/canada/ottawa/most-renters-skip-home-insurance-1.911039



    All you need to know about home-schooling #what #do #you #need #to #become #a #school #psychologist


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    All you need to know about home-schooling

    From overcrowded classrooms to ruthless bullies, some children fare better when their education takes place at home. We tell you more about home-schooling and some SuperMoms who have chosen it.

    Don’t take the decision to home-school lightly

    Mari-Lynn Kent, who started home-schooling her daughter Emma (11) this year, wrestled with the decision to home-school for about a year. “It’s a big decision and if you make the wrong choice, your child suffers.”

    A number of factors motivated Mari-Lynn to home-school her daughter. Emma has a very busy extramural schedule, but trouble with bullies at school and the sexual conversations between 11-year-olds on the playground were also motivating factors. “I felt the care wasn’t there, especially when it came to the bullying,” says Mari-Lynn. “The child sitting next to Emma was hitting her. I had to speak to the teacher three times before she was moved.”

    Discipline is key

    Home-schooling allows Emma to focus on her passion – dance. “We try to work ahead, keeping Fridays open for her extramural activities such as ballet, piano, drama and choir,” says Mari-Lynn.

    Mari-Lynn, a mother of two, has a very structured approach to home-schooling. A distance education company supplies her with a curriculum and tells her what textbooks she needs. “I wanted everything under one umbrella. The company also uses teachers to set up exams and the curriculum,” she explains. “They advise you on how much work you should do each week so you don’t fall behind.”

    What about exams?

    The company requires students to write exams in June and December. “She can write them at home, but there needs to be a moderator. I’m not allowed to moderate, but can ask someone else, who’ll have to sign an affidavit, swearing that Emma wrote in an exam environment.”

    If Emma then ever goes back to a traditional school, she will have the certificates to prove that her education is up to standard and she won’t have to write an entry level exam. Mari-Lynn plans on home-schooling her daughter until high school. “Emma wants to go to a traditional high school and if she still feels that way later, then I’ll send her to one.”

    A more informal approach

    Other parents prefer an informal approach to home-schooling, says Bouwe van der Eems from the Association for Homeschooling. “Some parents prefer to be guided by the child’s interests, focusing on the subjects their children are interested in. You don’t have to follow a one size fits all curriculum like a slave. Parents can pick and choose from a variety of curriculums.”

    How do home-schooled children matriculate?

    From Grade 10 onwards, you need to follow the national curriculum if you want your child to finish school with a South African matric qualification. A home-schooled pupil must submit projects and write exams just like those in traditional schools. Parents can do this through home-school curriculum providers.

    Many people prefer the international matric qualifications, like the British Cambridge or US GED diploma, over a South African matric. “These qualifications are recognised by universities. Unlike a South African matric qualification, you don’t need to complete and hand in projects. You just prepare and write the exams,” van der Eems says.

    Benefits of home-schooling

    • A child can work at her own pace, says Anel Annandale, a Cape Town child psychologist. “Often children who are home-schooled learn to take greater responsibility for their own learning and development.”
    • It gives you and your child greater flexibility when it comes to time, says Annandale. “It allows a child with a specific gift for a generally time-consuming interest, such as a gifted gymnast or horse rider, to schedule schoolwork around her practice and training schedule,” she adds.
    • “Peer pressure, bullying and high levels of competitiveness are less often a factor for home-schooled children,” Annandale says.
    • Home-schooling can lead to closer family relationships, says Raquel Ferreira, a Johannesburg educational psychologist. “Extended periods of time together strengthen family relationships, not only between the child and his parents, but also with his siblings. As they get to know each other, the family members form bonds that last a lifetime,” she says.
    • One-on-one tutoring means that there is more time available to actually learn and teach, says Annandale. “Teachers in traditional schooling systems often waste a lot of time on discipline issues which arise purely because of the large number of students in a class,” she says.
    • “Home-schooling is often better suited to children with learning difficulties because parents can focus more in-depth on specific subject areas that their children struggle with,” Annandale says. “Many of the behaviour issues that are often associated with learning difficulties, such as the hyperactivity and impulsivity that children with ADHD (Attention deficit hyperactivity disorder) often exhibit are tolerated more easily in a home-schooling environment than it may be in a traditional classroom.”
    • If a child can’t cope in traditional or remedial school, then home-schooling might be your best option, says Megan Robinson, an educational psychologist from Johannesburg. “Home-schooling can work well for the unique child who’s tried all other options and hasn’t coped. Similarly, a child who’s suffering from an illness or physical difficulty may have no other option. A child with a severe emotional or social disorder will also cope well in a home-school environment.”

    Drawbacks of home-schooling:

    • “Home-schooling often offers difficulty for university entrance and coping skills,” Robinson says. “Often children who go through home-schooling battle to adjust to the demands placed on them in the tertiary environment or in the working world.
    • Children might miss out on learning opportunities, she adds. “Normal schooling teaches the child about more than just the general curriculum and provides the developing child with vital skills and life lessons. For example, it teaches social interaction, discipline and structure, moral development, leadership skills and other valuable life skills.”
    • Children who are home-schooled often miss out on healthy competition and extracurricular memories, says Ferreira. “Parents need to involve their children in club sports so as to still allow this area of development.”
    • It might be impossible for parents to juggle work with home-schooling. “Often a parent has to stop working so that they have time to home-school, but this then has the associated drawbacks of loss of income for the family,” Annandale says.
    • Annandale warns that home-schooled children sometimes have fewer opportunities to socialise with other children their own age and may become withdrawn and reserved in social settings. “Children who are very sociable or really enjoy or excel at group activities and group sports generally fare better in a traditional schooling system.”
    • Some subjects are best taught by skilled teachers, says Ferreira. “Some home-schooling parents have a hard time with subjects such as algebra or physics. Parents may need to look into the use of private tutors for this reason.”

    Beware the challenges

    • Home-schooling is hard work, says van der Eems. “You need to prepare and be willing to make sacrifices, especially when it comes to your time. The home-school never closes. It’s open 24 hours a day, seven days a week.”
    • Home-schooling isn’t the norm, he adds, and not everyone might agree with your choice to home-school your child and you might often need to defend your choice.
    • Schools have more teaching resources than home-schooling parents. “Parents may not have access to the same resources that schools do. For instance, practically demonstrating a chemistry experiment may require a lot more effort and money than it would in a traditional school with a fully-equipped science lab,” Annandale says.

    Are you ready for the responsibility?

    Home-schooling is a huge responsibility warns van der Eems. “When you take your child’s education into your own hands, you take on a huge responsibility,” he says. “It can weigh on your conscience and you can question if you’re doing the right thing for your child’s education and their future. However, there are many support groups and internet discussion forums where parents can support one another and ask for advice.”



    What does a paralegal do compared to a legal assistant or a legal secretary? #what #does #a #bankruptcy #attorney #do


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    What does a paralegal do compared to a legal assistant or a legal secretary?

    Many clients wonder what does a paralegal do for me. The simple answer to that question is a paralegal does whatever tasks assigned to him or her by the supervising attorney to assist the attorney in representing the client. What does a paralegal do :

    • Assist attorneys during trials
    • Organize case files and prepare trial notebooks
    • Perform legal research on current laws and cases
    • Prepare legal briefs
    • Draft correspondence and legal documents
    • Conduct client and witness interviews

    In smaller firms, a paralegal may perform secretarial duties while she is completing assignments. For instance, if the attorney gives the paralegal a legal pleading to draft, she may type the document herself rather than dictating the document for a secretary to type. A paralegal may also do her own office filing, copying and mail outs instead of giving these tasks to other staff members. However, some paralegals may spend all of their time performing legal research, interviewing clients or drafting pleadings.

    Because there are no national standards or certifications for paralegals, it is up to the legal community as a whole to determine job descriptions. A paralegal’s job description will vary depending on the attorney, the type of law the attorney practices, the size of the law firm and the location of the law firm.

    Question: What does a paralegal do?

    Answer: Any task assigned to her by the attorney.

    What does a paralegal do that a legal assistant cannot do nothing. The National Association of Legal Assistants states that the terms legal assistant and paralegal are interchangeable. Therefore, a legal assistant may perform the same tasks for an attorney that a paralegal performs for him. However, some attorneys consider only assistants who have a degree to be a paralegal. Anyone without a paralegal degree performing similar tasks would then be considered a legal assistant. Smaller firms may use either term to describe the same position but larger firms and corporate legal departments will normally require a paralegal to have a minimum of an Associate’s Degree before they can use the title of paralegal.

    What does a legal secretary do?

    Now that you know the answer to the question, “What does a paralegal do?” you will be able to distinguish a paralegal from a legal secretary. A legal secretary types documents for the attorney from dictation, prepares correspondence, answers the telephone, greets and assists clients and maintains the attorney’s calendar. In some firms, the duties of a legal secretary may include some of the same tasks that would be assigned to a paralegal or legal assistant in larger firms. The same is true for legal secretaries as it is for paralegals they do whatever is assigned to them to assist the attorney and keep the law office running smoothly.

    Job skills required to be a paralegal, legal assistant or legal secretary

    To perform the legal tasks assigned to them by an attorney, legal staff members must possess certain skills. Computer skills are required because a growing number of law offices, and courts, are paperless. Good communication skills and strong organizational skills are essential since paralegals work with the public and under multiple deadlines. Attention to detail and the ability to multitask round out the qualities of a good paralegal.

    If you want to know how to become a paralegal, the first step you should take is finding an accredited paralegal program through a university or community college. Search for a paralegal school that has been accredited by the American Bar Association. Programs that have been accredited by the ABA have met the educational standards of the ABA’s Standing Committee on Paralegals. Some programs offer a paralegal certificate but those programs are usually very short and overly broad. An Associate’s Degree in paralegal studies offers a two-year degree. These programs are more in depth and provide a better foundation for a career as a paralegal.

    For individuals who desire to work in larger law firms, a Bachelor’s Degree is usually required. The advantage of having a Bachelor’s Degree, in addition to a paralegal degree, is that the student receives a more rounded education including courses in English, literature and history, which help develop good communication skills.

    How much does a paralegal make?

    The answer to this question depends on several factors. The factors that influence paralegal salary primarily are:

    • Education
    • Experience
    • Type of law
    • Location of law firm
    • Size of law firm
    • Attorney’s attitudes and preferences

    According to the Bureau of Labor Statistics, the median income for a paralegal is $46,680 per year. However, this does not take into consideration many of the individual factors listed above. Salary.com reports that the median income for a paralegal is $47,377 per year; however, you can narrow this figure by entering the location of the job. The region’s cost of living and the salary trends for that specific location will also affect the average salary of paralegals.

    It is important to remember that paralegals holding a Bachelor’s Degree often earn more than paralegals without a degree; however, there are exceptions to this rule experience and the attorney. Some attorneys give more weight to experience over education because no matter how much education a paralegal may have it can never be substituted for real world experience. In order to increase base salary, a paralegal can focus on a specific area of law to obtain more experience.

    Is becoming a paralegal a good career choice?

    Now that you know the answer to the question, “What does a paralegal do?” you may want to know if being a paralegal is a good career choice for you. The Bureau of Labor Statistics reports that jobs in the paralegal field are expected to increase by 18% between 2010 and 2020. Therefore, paralegal graduates can be optimistic with the outlook for the career.

    Furthermore, careers in the legal field will not likely disappear with changes in the economy. Individuals will continue to need the services of an attorney for various life events such as buying a home or preparing a will. In addition, as attorneys seek ways to cut overhead, corporate law firms try to reduce in-house legal costs and clients demand lower legal fees, the role of a paralegal will become increasingly more important since a paralegal can perform many of the same tasks as an attorney but for a much lower rate.

    Posts related to What does a paralegal do compared to a legal assistant or a legal secretary?