I found an interesting website that predicts a website user’s age, gender, and other demographic information, based on their online behavior, such as what queries they search online and what sites they visit.

All you have to do is type in a topic or web address, and this tool gives information pertaining to what demographic is interested in the topic. For example, if you typed in my URL, Nursing Home Talk you would find that 71% (as of today) of the readers are female compared to males. So, if you are curious to know what age group, for example, is interested in home health in your area, this may be a tool to check out.

Here is the link:

Demographic Prediction Tool

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home health

For those of you who have asked…here, finally is my recommendation for taking the nursing home administrator exams. Not to sound overly confident, but I had no trouble with either test (NAB or state). Of course, I listened to some very wise people in deciding what to do. At the time my preceptor said, “don’t even attempt” to take these exams without a review course. She claimed books and study guides were insufficient on their own.

For the most part, I would agree with her. The material I received from the review courses was by far the most relevant. Originally, I looked into a lot of different avenues. For example James E. Allen has a long term care administration online review course which runs about $600 for both parts. At the time, I was student and this was far more than I could afford. So instead I bought a few books that had been recommended, and decided to sign up for a local review course, which cost me about $150 each.

Below I have listed out a few books, I would recommend to those taking the NAB exam. The most relevant is the NAB Nursing Home Administrators Examination. I read this book several times, and each time I found more relevant material. When taking the exam, it seemed many questions came directly from this text.

Whatever you do, take your time to review all material so you feel prepared. Know your weaknesses, and properly study for them. If you need any help or have questions, don’t hesitate to contact me.

Recommended Books & Study Guides:

NAB Nursing Home Administrators Examination

Principles to Health Care Administration

The Licensing Exam Review Guide in Nursing Home Administration: 1000 Test Questions in the Nation Examination Format on the 1996 Domains of Practice

The Licensing Exam Review Guide in Nursing Home Administration: Fifth Edition

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nursing home administrator, James E. Allen, long term care administration

Honesty is something we expect from most people. We assume that the cashier will accurately give us our change, the police officer will protect us from criminals, and our boss will pay us on time for the work we do. Unfortunately, not everyone treats us fairly.

Yesterday someone close to me was robbed in Ocala. Two men wandered up to her property the day before, asking for farm labor. They claimed to be hard workers and would do a good job for her. Needless to say, she hired them on the spot. To her surprise the next day, all her lawn equipment and tools had been stolen, adding up to about $4,000. This left her feeling violated and extremely angry.

She stated, “How could they do such a thing? When no one would hire them. I gave them work and paid them fairly. Why couldn’t they treat me with the same respect?”

Later, she found out from the police that these men had long criminal records including assault. One of the men even had a warrant out for his arrest. Although this incident is truly upsetting, she is fortunate to be alive.

Honesty is something my friend expected, and they violated it. In long-term care, we often entrust strangers to provide quality care. But truly–how do we know they are honest individuals? And, how do we know they will do a good job? Hiring someone new is a gamble…that’s why people often look to an outside agency to provide quality workers, and also to take on the liability.

Most companies whether nursing facilities or home health agencies, thoroughly background screen their employees. If these dishonest men had worked in the health care field, they likely wouldn’t have been hired. At the same time, if my dear friend had checked into their background, she would have been aware of their dangerous history.

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I recently read an article on unique living environments entitled “Finding the Perfect Niche” by Maureen Hrehocik. This article discusses the more recent popularity of niche housing for older adults needing long-term care.

One of the fastest growing senior housing niche markets are for gay, lesbian, bisexual, and transgender individuals (GLBT). A member of the new GLBT community points out that she feels “more at home with people who share her (my) values.” This is especially so for those abandoned or disowned by family due to their sexuality. With the rising popularity of these communities, individuals who are gay, lesbian, bisexual, or transgender now have somewhere to live and grow old with their peers.

Another area on the move is university-based retirement communities (UBRC). While living in Austin, the University of Texas was making plans to open one of these facilities on campus. Currently, there are about three dozen university based retirement communities (UBRC) open in the United States. Most of the UBRCs meet the following criteria:

- The community must be located within a mile of the main campus.
- At least 10% of residents are expected to have affiliation with the University, whether as alumni or retired faculty.
- The community should be a Continuing Care Retirement Community (CCRC) providing all types of care, whether it’s independent, assisted, Alzheimer’s and/or skilled nursing.

Various cultures have also created niches for themselves. For instance, one Asian American nursing facility in California has two stone lions marking their entrance. No where in this facility will you find the number “4″, which signifies death to some Asian Americans. Also, the color blue is absent from the decor, because it is considered “undesirable.” These facilities have gained popularity because some prefer to be among those that have similar beliefs or customs.

Some seniors choose more non-traditional methods of retirement living. Since the year 2000, Bea Muller has been living on the Queen Elizabeth 2 cruise ship. Her “assisted living” choice runs about $100,000 dollars per year. This cruise ship visits twenty-five countries per year. A study done by the American Geriatric Society (2003) discovered that the average cruise ship only costs around $11 dollars more per month than an a assisted living facility.

These days it’s not uncommon for cruise ships to have a “Bea Muller” type staying long-term. A cruise line called Residen Sea, has introduced “The World,” a ship that allows retirees to buy high-end apartments. Since cruise lines already have nurses and physicians on staff, it makes sense why some consider this type of retirement living.

With the large number of Americans retiring, it’s no wonder the options continue to grow. There is no doubt that Baby Boomers will reinvent the previously generic term “retirement.”

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Just a quick note to congratulate Jennifer Mikula who is Florida’s Nursing Home Administrator of the Year! I am proud to say she runs one of our local facilities, Palm Garden of Ocala.

Jennifer was nice enough to give me a tour of her facility a few months ago. With her visionary mindset, she has made many changes that have improved the quality of life of Palm Garden’s residents. For example, instead of having a standard hospital-like shower room, Palm Garden now has a Spa. These days residents who use to avoid bathing now line up to enjoy the beautiful tiled room with stained glass windows and a nail tech.

Palm Garden also has a quiet zone. In this silent area, residents can relax and enjoy the smell of fresh baked bread (also to eat), the sound of water flowing, and places to sit and nap if one so desires. According to Jennifer, residents who normally tend to be combative or act out, seem to change in this still and relaxing environment. In this comfy and cozy room, I don’t see how anyone could stay upset long.

For nursing home residents, I am glad to see these improvements and hope more Medicare/Medicaid nursing homes will join Jennifer in continuing to reinvest in their facilities.

Long-Term Living recently featured Palm Garden of Ocala in their magazine. To read this article, click on this link.

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For those of you who are Florida Nursing Home Administrators or are health care managers in North Central Florida, I would encourage you to attend the Florida Health Care Association’s (FHCA) district meeting. This is an excellent way to meet some of your peers, along with gain knowledge on important topics related to the field and our community. Below I have listed information pertaining to the meeting, which is also posted on www.fhca.org.

DISTRICT VIII
David Minnic, President
Hawthorne Health and Rehab of Ocala
Phone: (352) 237-7776
Fax: (352) 237-5551
District VIII Meeting Information
Date: 2nd Thursday of each month
Time: 11:30 AM
Location: Ocala Hilton, Ocala

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Recent clinical trials aimed at halting Alzheimer’s disease (AD) have proven to be elusive. Two of these drugs, Flurizan and Alzhemed had researchers hopeful for a little while. After failed clinical trials, the drugs were found to be ineffective. This was very disappointing news, since these two drugs had been built up as a possible “cure” for the last couple of years.

Currently there are five Alzheimer’s disease medications available to the public. However, all of these drugs treat the symptoms such as confusion and memory trouble. They do not cure or even slow down the disease. A study published earlier this year concluded that these drugs produce few, if any, meaningful benefits. From my experience, I have seen positive results from these drugs (i.e., Aricept), but whose to say if the results are largely induced by a placebo effect.

Although researchers remain optimistic, other candidates that could provide a cure appear to be in the distant future, 2010 or beyond. For example:

- A drug called bapineuzumab, which uses antibodies to clear beta-amyloid is about to enter Phase III trial. Results of this drug are due in 2010.

- Another drug, Dimebon, discovered more than two decades ago has completed Phase II trial in Russia. So far results from this study have found that patients seem to have improved thinking processes and ability to function. It will be interesting to see how this drug continues to do in Phase III trial.

While we wait for a cure, Congress has been trying to pass a bill entitled the “Alzheimer’s Breakthrough Act” (used to be called the Ronald Reagan Alzheimer’s Breakthrough Act) that would increase research funding.

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Often in the early stages of Alzheimer’s disease, I have had caregivers come to me and ask:

– “Dad keeps forgetting how to act in public. The other day he started to take off his clothes in the grocery store. What can I do to stop him?”

– “I am completely exhausted from caring for my wife. The moment I take a break, she is headed for the front door, or attempts to use the stove or other unsafe appliances. How do I keep her safe?”

These are just a couple of examples. A caregiver of these individuals has a lot of responsibility which can often lead to stress, and sometimes burnout. Just in Marion County it has been estimated that 11,455 persons have been diagnosed or show signs and symptoms of Alzheimer’s disease or related dementia.

Marion county has been very fortunate in the last year. A new not-for-profit organization began that specializes in this field. It is called The Alzheimer’s & Dementia Alliance Education & Support Inc. (www.adaesinc.org), led by Terrie Hardison of Ocala, Florida.

The purpose of this organization is to bring knowledge and hope to caregivers, the community at large and professionals through education and support. As a volunteer for this organization, I have seen many benefit from their services.

In a way, Marion County should thank the Alzheimer’s Association for the origin of this new organization. Prior to the Memory Walk of 2007, Terrie Haridson ran the local headquarters for the Alzheimer’s Association in Ocala. Unfortunately, after the county raised significant funds for the Memory Walk, it was canceled due to rain. Following this event the local Alzheimer’s Association office was abruptly shut down.

Soon after Terrie Hardison began the Alzheimer’s & Dementia Alliance for Education & Support (ADAES). This organization now gives a voice to local caregivers. While the Alzheimer’s Association continues to remain a national figure for Alzheimer’s research, I would recommend to local caregivers and those interested in volunteering to catch a course offered by ADAES. You won’t regret it.

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Recently, I learned of a V.A. aid and attendants program available to veterans or their spouses. Under this program, a veteran can receive a maximum of $1673.00 per month in benefits, and a spouse can receive up to $869.00 per month.

To qualify for this program a veteran must have had 90 days or more of active duty, only one day of which was during wartime. It is not necessary that they saw combat. They must not have had a dishonorable discharge.

In addition, the veteran or spouse must be determined to be “permanently and totally disabled.” This includes but no limited to: trouble dressing/undressing him or herself, blindness, and mental or physical incapacity.

The veteran or spouse does not need to be house bound or considered helpless. You just have to prove the person is in need of aid and attendance on a regular basis. The V.A. will generally accept a letter from a physician, which should state that the person has an incapacity that requires care or assistance on a regular basis to live safely at home.

There is a net worth requirement for this program. This is something the V.A. could assist you with since it changes on a routine basis. The last known net worth cutoff was $80,000, not including your home.

In addition to the net worth requirement, there is also an income requirement. The veteran’s countable income should not exceed the maximum annual pension rate which is currently $1,673 (adjusted periodically), or $869.00 per month for the spouse. However, some items may be deducted from income in order to meet this criteria. For example: doctor and dental visits, co-payments, medical supplies, therapy, transportation to the doctor, ect.

It can take up to ninety days to receive approval. However, once approved payments are made retroactively from the first month after the month that you apply. So, funds you previously spent on home care may be reimbursed to you when the V.A. aid and attendants coverage starts.

This information was provided by Interim Healthcare Private Services (Ocala, Florida), which provides quality home care to veterans and others needing assistance. To view their website, click on the link: www.interimhealthcare.com

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V.A., veterans, Interim Healthcare Private Services, Ocala, Florida

Recently, I had a friend tell me about her grandfather who was left outside all day at a facility in the Ocala/Gainesville area. In Florida, it isn’t unusual to experience 100 degree days. Imagine being trapped outside without water, food, or a toilet. Where were the employees to assist him? The bigger question–why was he not missed? Unattended, this poor man suffered as a result of neglect.

There are many types of abuse such as: physical, mental, verbal, sexual, and intellectual/spiritual abuse. Neglect is considered a more passive form of abuse. For example, if your job was to change Mrs. Smith’s depends every evening, and you knowingly decided not to, and as a result she sat in urine for hours, you passively abused the rights of Mrs. Smith.

As with all types of abuse, they can eventually cause severe mental or physical damage. Sometimes the symptoms can be obvious such as a change in personality or physical evidence (i.e., severe bruising). One must be careful in making assumptions too quickly, because false claims could really damage the name of a reputable nursing home.

For example, one facility where I worked the family called the state to do a thorough investigation because their mother’s arms were severely bruised. Afterwards they found out that the bruising was mostly caused from taking her new medication, Coumadin.

If you believe your loved one or someone else is being abused, it is important to investigate it. Nursing homes have social workers, which can act as your advocate. Another option is your local ombudsman, which is unaffiliated with the nursing home. Information to finding the your nursing home ombudsman can be found at the facility.

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