In October, MetLife published its latest annual report on home care, nursing home, assisted living and adult day care costs.  From 2010 to 2011, the survey showed that the  national average hourly rate for home health aides remained unchanged at $21.   In the Northern Virginia area, the figures also remained unchanegd from 2010.  In this area, rates range from $17 to $24 per hour, with the average being $20.  (Ready Hands Home Care currently charges $20 per hour for home care services performed by its Certified Nurse Aides.)  National average costs for other categories of long-term care rose anywhere from 4.4% to 5.6%.  A private room in a nursing home, for example, now costs an average of $229, while in Northern Virginia the figure is $277.  Download the full report here: http://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-market-survey-nursing-home-assisted-living-adult-day-services-costs.pdf

America’s burgeoning senior population will require creative new strategies for successful aging in place.  One such strategy is embodied by the “Village” concept, pioneered by Beacon Hill Village in Boston, Massachusetts.  Conceived in 1999, Beacon Hill Village is a non-profit 501(c)(3) organization that makes a broad range of services available to its members through volunteers, selected service providers and strategic partnerships.

Now often referred to as an “aging in place community”, the Beacon Hill Village model has spread to over 60 similar community organizations nationwide, with many more under development.  Although their offerings and resources vary, Villages share certain common features: they are grassroots organizations driven by neighborhood seniors who are determined to stay in their homes; they are primarily supported by and governed by resident members, who usually pay a regular membership fee; their central function is the coordination of access to affordable services, which can include anything from transportation to home repairs to social events to in-home personal care; they offer pre-screened providers who often discount their services to members; they depend heavily on neighborhood volunteers.

In Virginia, Maryland and Washington, D.C. there are now 12-14 open Villages and another 17 or so in the planning stages.  Mount Vernon at Home is one example.  It opened its doors in 2009 and now has about 180 dues-paying members.  According to its Executive Director, Barbara Sullivan, the organization now boasts 80 volunteers and has 250 preferred providers on its list.

Sullivan points out that starting and sustaining a Village requires hard work and careful strategic planning.  Since each community is different, planners must think early on about the specific needs of area seniors.  “Transportation was one of the biggest needs for our seniors.  If they don’t drive, they still must be able to do shopping and get to appointments,” said Sullivan.  Social connectivity and minor household repairs were other areas where the organization found it could provide value.  Mount Vernon at Home volunteers do myriad seemingly simple tasks that can be problematic for the elderly–everything from troubleshooting a computer to replacing a ceiling bulb.  “You’d be surprised at the requests we get from our members,” said Sullivan.

An ongoing concern for Villages is sustainable financing.  According to Sullivan, Mount Vernon at Home gets about 60% of its funding from membership dues.  The rest has to come from elsewhere, including charitable donations and federal, state and local grant monies.  Governments and private entities concerned with aging in place are taking notice.  The D.C. Office of Aging, for example, gave $15,000 to help launch the DuPont Circle Village in 2009.  The Village earlier received a $3,000 grant from the DuPont Circle Citizens Association.

Besides funding concerns, there are other challenges.  It is unclear how successful the Village model can be in low-income communities or sparsely populated rural areas.  In addition, neighborhood residents are not always receptive to the idea of paying hundreds of dollars in yearly dues.  Nevertheless, Mount Vernon at Home’s Sullivan is confident that neighborhood Villages are here to stay and will play an essential role in allowing seniors to remain safely in their home communities.

One of the concerning trends we’ve seen in recent years is the rapid growth of “hospitalists”–physicians who work full-time for hospitals and handle the care during inpatient stays.  What we have noticed is a big problem with lack of continuity and coordination with the patient’s regular primary physician.  Since Ready Hands Home Care is frequently called upon to provide in-home services atthe time of hospital discharge, we run into foul-ups all the time that result from this system.  Medications prescribed at discharge often don’t include maintenence drugs that the patient should be on; primary physicians are in the dark about what went on during the hospitalization; follow-up arrangements are shaky.  The hospitalist boom has certainly been driven by money concerns, but one would at least hope that a dedicated inpatient doctor could deliver better care by virtue of being on site.  Now comes evidence that the hospitalist movement may be increasing overall costs by leading to more post-discharge expenses and more readmissions.  Read more here: http://newoldage.blogs.nytimes.com/2011/08/12/do-hospitalists-save-money/?ref=eldercare

White House Endorses Kerry, McDermott Legislation to Close Tax Loophole That Hurts Workers and Businesses

For Immediate Release: Wednesday, September 15, 2010

CONTACT: DC Press Office, 202-224-4159

WASHINGTON, D.C. – The White House has endorsed legislation by Senator John Kerry (D-Mass.) and Representative Jim McDermott (D-Wash.) to protect workers from losing benefits and protections as the result of a tax loophole.

The Fair Playing Field Act of 2010, which Kerry and McDermott introduced today, will close a tax loophole currently allowing businesses to misclassify workers as “independent contractors,” thereby creating an unfair environment for businesses that play by the rules and an unfair environment for workers. The bill is cosponsored in the Senate by Senators Kirsten Gillibrand (D-N.Y.), Patty Murray (D-Wash.), Sherrod Brown (D-Ohio), Al Franken (D-Minn.), Daniel Akaka (D-Hawaii), Chuck Schumer (D-N.Y.), and Patrick Leahy (D-Vt.)

“When employees are classified as independent contractors, whether by design or because the rules are unclear, they are denied access to critical benefits and protections, at significant cost to government at all levels,” said Vice President Joe Biden. “For these reasons, stopping worker misclassification is a priority for the President’s Middle Class Task Force, which I chair, and I applaud Senator Kerry and Congressman McDermott for introducing this bill. The legislation is timely, as misclassification is an increasing problem, one that puts employers who properly classify their workers at a disadvantage in the marketplace and costs the government billions of dollars in unpaid taxes. I urge the Congress to stand up for workers and create a level playing field for law-abiding businesses by supporting this bill.”

“This reform is pro-worker and pro-business,” said Sen. Kerry. “Today a tax loophole is being abused to deny workers basic protections and benefits. We shouldn’t reward those who game the system while hard-working Americans are denied their due protections and businesses that play fair are disadvantaged.”

“For too long, the misclassification of employees has put an unnecessary financial strain on American businesses and workers,” said Rep. McDermott. “Having a distinction between independent contractors and full-time employees is a good thing, but the current law is leading to significant abuse. Companies that misclassify workers have an unfair advantage over companies who play by the rules. Misclassification also leaves hard-working American families vulnerable to an uncertain economic future. This new bill makes important changes to the original by making sure there is a smooth transition to a clear obeying of the rules and it gives the IRS the tools it needs to even-handedly enforce those rules.%

via John Kerry – United States Senator for Massachusetts: Press Room.

It’s a troubling paradox. As medication breakthroughs offer new hope for treating disease, medication errors are harming more and more Americans. On the plus side, the treatment of virtually every major illness has been revolutionized in recent years by the advent of better agents. Take diabetes. Not so long ago the only drug treatment options were insulin and a handful of fairly primitive oral agents. Today physicians can choose from at least five different classes of pills and ten insulin formulations. At the same time, scientific studies clearly demonstrate that aggressive treatment greatly reduces diabetic complications. Thus diabetes today is often treated with combinations of two or more complementary drugs. » Continue reading “Medication Errors: The “Other” Drug Problem”

Ready Hands Home Care is often contacted by the adult son or daughter of an elderly parent to arrange in-home help.  Quite often, it turns out that the parent does not feel that he or she needs help in the first place.  Sometimes no amount of reasoning or persuasion can overcome the disagreement, and we back away until the family can come to terms among themselves. » Continue reading “Convincing a Parent to Accept Home Care Assistance”

Driving is seen as a practical necessity for most Americans as well as a symbol of independence.   It is little wonder that few people will easily give it up.  Yet for individuals with Alzheimer’s disease, operating a motor vehicle can pose serious increased risks to themselves and others.  The decision of when to stop driving is one that Alzheimer’s disease patients and their families often face.  This article provides some guidelines for approaching this sensitive issue. » Continue reading “How to Address Driving Impairment in Alzheimer’s Disease”

A host of new technologies now makes it possible for adult children to monitor elderly parents and thereby permit them to remain safely at home.  From tracking systems, medical monitoring, medication compliance checking and more, technology and the internet now offer new strategies for ensuring the safety of seniors living at home.  Click the following link to read more: Monitoring Elderly Parents – NYTimes.com.

Over 40 million Americans have cared for a loved one with illness or disability during the past year.  If you’re one of them, the holiday season may pose exceptional stresses.  Why should the holidays, usually associated with joy and good cheer, be especially taxing for caregivers?  » Continue reading “Holidays Pose Stresses for Family Caregivers”

Home care is a very fragmented industry with many small companies competing for business, especially in heavily populated urban areas. The quality and professionalism of home care companies varies greatly. To protect yourself or your loved one, you should do some advance screening before making a commitment to use any one company. Here is a handy list of important questions you should not fail to ask. » Continue reading “Checklist for Choosing a Home Care Agency”