Good News for the Elder Care Industry

The first wave of the Baby Boomers turns 64 this year. It won't be long until they start the biggest retirement exodus this country has ever seen. It's time for companies to prepare, because the Boomers are being replaced by a much smaller generation of unskilled workers. With the unemployment rate close to 10%, it's hard to imagine, but in just 8 short years our country could have as many as four million more jobs than workers to fill them.

So what's the good news for us in the elder care industry? First, the idea of a traditional retirement is outdated. The 60-somethings want to continue to work, and make a difference. They want flexible, creative work that accommodates their lifestyle. I can think of a fabulous profession that meets all that criteria...professional caregiving! Additionally, many of the soon-to-be retirees already have experience, in caring for their aging parents.

As an HR professional, it is my duty to keep on top of up to four generations that are in the current workforce, and understand the needs and traits of each. In the elder care industry, however, the most common generation is the Boomers. Let's inform these new retirees of this growing, purposeful career and help reduce the gap between open jobs and skilled workers.

Medicare Part D Open Enrollment

Medicare beneficiaries take note! The annual election period for prescription coverage under Medicare Part D will take place from November 15 through December 31 for coverage beginning January 1, 2011.

Why is this significant? There is only one enrollment period per year when you can change coverage. Different Part D plans offer varying coverage for certain medications, so you may wish to change Part D plans if you have experienced any health problems over the past year which have resulted in medication changes. Or, if you have added up your medication expenses and feel you may be able to get better coverage under a different Part D plan, you may wish to "shop around."

You can use the formulary finder on the Medicare website to search for the Part D plans in your area that cover most or all of the medications you are taking. You will be prompted to enter a list of your medications and dosages, and then you will be provided with a list of Part D plans, their monthly premiums, and customer ratings of each plan.

Generally you can only switch Part D plans during the annual enrollment period, though there are certain exceptions, called Special Election Periods (SEPs). You may have an SEP if you experience a special circumstance such as moving into a nursing home, or losing your Medi-Cal benefits. If you are currently covered under a union or retiree plan and this plan stops offering prescription drug coverage in the future, you can join a Medicare Part D plan without a penalty as long as you do so within 63 days of the end of your existing coverage.

Medicare Part D coverage can be confusing, but there are resources out there to help. Great information on Part D coverage, as well as Medicare and other health insurance options for seniors, is available at the website of California Health Advocates. You can also call the San Diego Health Insurance Counseling and Advocacy Program (HICAP) office at (858) 565-8772.

Quality of Life

Quality of Life is tied to perception of 'meaning'. The quest for meaning is central to the human condition, and we are brought in touch with a sense of meaning when we reflect on that which we have created, loved, believed in or left as a legacy.
- Frankl VE. 'Man's search for meaning.' New York: Pocket Books, 1963.

I have had the pleasure to work with a wonderful and talented woman whose art has brought joy to many, and most importantly herself. She has patented a particular style of batik and created and sold her work but has not been able in past years to express her artistic talents.

Elder Care Guides holds as one of its main beliefs the importance of helping our clients achieve "quality of life." Knowing my client's passion for her art, I set out to discover a means to help her create again and with much luck, discovered a great resource by the name of Kat Kirby.

Ms. Kirby is an Art Therapist who believes in the "healing power of the arts" and that one should have a "good time during the process." Her studio, 2KatStudios, offers workshops in collage, mosaics and other creative pursuits. To find out more about Kat, check out her websites here and here.



Kat's patience, expertise and own excitement in creating has brought my client the opportunity to express herself, to hope and to create a legacy once again.

We Love Carrots!

I recently attended the 62nd Annual SHRM Conference, the largest HR Conference in the world with over 11,000 attendees from 140 countries. As you can imagine, the general and breakout sessions were packed with valuable information on managing, supervising, and engaging employees. However, one session that stood out above the rest was "The Carrot Principle: How the Best Managers Use Recognition to Engage Their People, Retain Talent and Accelerate Results," presented by Chester Elton.

Elton is a dynamic and insightful speaker, who engaged the audience by encouraging participation, using multiple types of visual aides, and even throwing stuffed carrots into the audience. His message, backed by years of research, was simple: recognize your employees for a job well done frequently, specifically, and immediately, and they will feel valued and appreciated. As mentioned before on this blog, valued and appreciated employees stick around. The metaphor of the carrot as it relates to business is "something used to inspire and motivate the employee." In Elton and Adrian Gostick's book, it states:

"When employees know that their strengths and potential will be praised and recognized, they are significantly more likely to produce value."

So how does this relate to employees that care for elders for a living? The demographic that makes up the majority of caregivers, are those that live paycheck to paycheck. Don't those employees just want more money? Nope. At least, that's not what Elton and Gostick reported. One-third of people you give a cash award to will use that money to pay bills, and one in five won't remember in a few months how much they received or where they spent the money. But they will remember receiving a hand-written note from their direct supervisor, or better yet, the President of the company, thanking them specifically and timely for something they did that was above and beyond. If those appreciative notes and phone calls keep coming, employees will keep going above and beyond, because rewarded behavior gets repeated.

I highly recommend Elton and Gostick's book and website. Read them, study them, and implement a recognition program. Your employees will appreciate it, and become motivated to do better and be more committed, which directly translates to your companies mission, goals, and values.

A Little Bit of Fun

Sharing some laughter! Click on the photo to enlarge, and enjoy!

The spaces between my fingers

Earlier this week, I had the opportunity to meet the folks behind an inspiring grassroots movement whose mission is to raise awareness about Alzheimer's disease and share wisdom between the generations, called The Spaces Between Your Fingers. Matthew Smith is currently engaged in a 30-day road trip across the country, using supplies that he purchased last year with his life savings to facilitate several 90 minute workshops in 13 different cities -- with, I imagine, some unplanned stops along the way. Participants come together in small groups and Mr. Smith shares a brief personal story of the life and loss of his grandfather, Dr. William McNamee, who died of Alzheimer's disease in 2003. In a letter to his grandson he asked him to think of him when he looked at the spaces between his fingers:

"Any time you want to find me, you don’t have to look far. Just look down at the spaces between your fingers—where my hand used to be—and instead of thinking of all that’s keeping us apart, remember this great force that’s holding us together, and always will."

Through some facilitated questions and discussion, participants are guided through memories from their childhoods, think back to lessons learned throughout their lives, and conjure up a piece of wisdom that they've gained and would like to pass on to the next generation. On a postcard, they trace an outline of their own hand, and then fill it in with their advice. Mr. Smith is collecting thousands of these postcards from individuals of all ages around the country, and will eventually combine them into a physical art installation and book, which will be used to promote awareness about Alzheimer's disease.

I am a volunteer co-facilitator of a support group for individuals living with early-stage memory loss that is held on Wednesdays mornings at the San Diego/Imperial County chapter of the Alzheimer's Association, who was contacted by Mr. Smith with a request to provide this free workshop to a group of individuals living with memory loss. The idea of the project was met with enthusiasm by our support group members, and we've been looking forward to his arrival on the west coast. The workshop this week was a great experience for the participants, sharing stories from their childhoods and early careers (a few of which I had heard over the seven years I've been facilitating the group, but most of which I had not). The telling of old stories by an individual who is progressively losing their memory is always a profound experience, and it's an honor to be there to receive these fleeting treasures. Wednesday mornings are always a highlight in my week.

Naturally, my mind wandered away from the table a few times and I got to thinking about my own childhood, the people who have influenced me, and some important lessons I've already learned in my short 35 years. Not many days go by that I don't think about my maternal grandmother Phyllis, who was - and is - a central figure in my life, and died in 2005. The summer that I was fourteen, my grandma undertook the task of teaching me to sew. She was an amazing seamstress, and had passed her skills along to her own talented daughters as well. My mom had not yet had an opportunity to teach me to sew; she was raising her three kids in a different era that required her to work full time and manage a busy household. But this is the gift of grandparents! They have time and space in their days that the rest of us simply don't have, and Grandma had decided that it was time that I learned. My first project was a black calico print dress that I'll never forget. I remember selecting a pattern in the shop, browsing for fabrics, and the afternoons of learning to cut, pin, and press, and getting familiar with the feel of the sewing machine on countless scraps in my grandma's sunny sewing room. It frustrated me to spend days practicing before I could even make the first cut into that pretty black fabric, but Grandma was adamant. That summer she taught me the importance of not just "doing things," but doing them right. She taught me that anything I make should look as good from the inside as it does from the outside. Straight stitching and clean seams (even if other people will never see them) not only make your clothes fit better, but they make you feel good about your work when you put them on. The things that I do in life need to not just look good to other people from the outside; they need to look good to me from the inside as well. I hope that Grandma Phyllis knew how important that time that summer with her was, and I suspect that she did. Today whenever the spaces between my fingers are filled with pins and crinkly tissue paper, or are guiding a piece fabric through a sewing machine, I think back to that sunny room and all of the love and laughter there, and that little bit of becoming who I am.

What a gift my grandmother was to me -- and that all members of an older generation are to those who follow them. Those of us who spend our days engaged in service to our elders are constant recipients of these gifts, and every day I know I chose the right path. I thank Matthew Smith and everyone who is supporting him in his project for this opportunity to spend some time in personal reflection, and for providing the members of our support group who live day in and day out with the frustration of a failing short-term memory with this valuable opportunity to tell stories and teach lessons. To answer Dr. William Thomas' important question: this is what old people are for.

The Aging Caregiver Workforce

In the elder care industry, most focus on the clients, or the elders, and rightfully so. It is them for whom we care, center our business on, and assist in finding their purpose as they move through their elderhood. But what about the caregivers? At what place in their life journey are they?

Research shows that 22 percent of home care workers, or caregivers, are 55 or older. And that number is expected to grow to 30 percent over the next decade. Traditionally, most companies may be reluctant to hire and older worker for fear they aren't as productive, slower to catch on to new technologies, and could cost the company more in health benefits. Not so in the elder care industry.

Older workers are not only preferred, but sought out as caregivers. The typical older worker not only has experience caring for aging family members, but understands the stresses families are under, has respect for age, and doesn't see age as a disability. Most often, a good match can be found between an older caregiver and an elderly client, because of the greater chance for common interests and hobbies.

Additionally, the caregiving profession is often the perfect fit for an older worker. The flexible hours, the part time hours for those not needing health benefits, and most importantly, it creates a sense of purpose, caring for someone who values their help, something they enjoy doing, and do well.

We Have A Winner!

Elder Care Guides is proud to announce that one of our caregivers, Maricela Pulido, received the award for Outstanding Home Care Service from the California Association for Health Services At Home. The award is given to an individual who is "directly involved in day-to-day care and has consistently provided outstanding service to patients in their homes." Maricela was honored with this award at the CAHSAH National Conference luncheon in Sacramento, CA on May 6, 2010.

Maricela was nominated because she not only has worked for Elder Care Guides since 2004, but she has been a caregiver for the same family for over 12 years. Maricela has managed the changing medications, the bathing routine, the various outings, all while keeping in mind her clients strengths and giving him a sense of purpose during his elderhood. Maricela is punctual, dependable, and has been throughout her tenure with this client over the last decade. She has developed a trust with her client and his family that is beyond measure. In addition, Maricela has been a consistent, reliable caregiver, rarely taking time off and always being flexible with the changing needs of her client. For all these reasons and more, Maricela was nominated for, and won this prestigious award! Congratulations Maricela!

A Great Time to Be A Caregiver

"The Great Recession," as it's now dubbed, has affected all of us in one way or another. The healthcare industry, especially home care, is expected to grow exponentially over the next decade. Employment statistics show the caregiving profession grew 26% from 1996 to 2006, thanks to aging baby boomers and the 85+ group, which is the fastest growing segment of the population. According to the Bureau of Labor Statistics, caregiving is the second fastest growing occupation in the country, and is projected to grow by 51% between 2006 and 2016. This is due to a multitude of factors, which primarily include the ability to treat and manage many health conditions at home with the help of a professionally trained aide, and elders increasing desire to remain in their homes where they can keep control and independance in their lives.

Caregivers provide a greatly needed relief to family caregivers, a consistant source of companionship to elders, and expert skills assisting with activities of daily living, all combined with a warm, friendly touch. These factors and more make staying at home the most appealing option to elders, vs. relocating to an assisted or skilled nursing facility. These labor statistics further prove that not only is professional caregiving an honored occupation, it is in great need and promises to be a wise career choice for years to come.

You can read more about professional caregiving and the nations employment outlook in the March issue of Caring Magazine.

Quality of Life Programs

Elder Care Guides is happy to promote two special programs created for people with mild-to-moderate Alzheimer's Disease. These wonderful programs were developed by the University of California, San Diego's Shiley-Marcos Alzheimer's Disease Research Center in collaboration with Elder Care Guides, Senior Life Assistance, The San Diego Museum of Art, Mingei International Museum, Timken Museum of Art and the Museum of Photographic Arts in Balboa Park.

The Out and About Program is a series of eight weekly outings, including lunches, that offer opportunities for socialization, learning and a feeling of independence for those with early stage Alzheimer's. The groups have various meet-up spots throughout San Diego county. They offer a variety of experiences for example; touring a museum, attending IMAX movies or even visiting the Chula Vista Nature Center.
All outings have a docent who knows how to conduct the group by providing information in an informative yet understandable way . The camaraderie that develops among the participants is probably the most beneficial aspect of these outings, knowing that they can share some of their fears and concerns in a safe and welcoming environment.
For the participant's safety, Outing Coordinators drive the them to all destinations. There is a cost which covers all entrance fees, lunches and mileage.

Another Quality of Life Program is called Memories at the Museums. This program allows the person with Alzheimer's and an accompanying family member or friend to tour one of four participating museums in Balboa Park and then discuss their experiences. This stimulates both the visual and verbal abilities of the of the participants and allows for cultural expressions.
Memories at the Museum is on the second Friday of each month from 2:00-3:00. Admission and tours are free of charge but registration is required.

For more information on either of these Quality Programs please call Lisa Snyder at the Shiley-Marcos Alzheimer's Disease Research Center at (858)622-5800.

The Power of Purpose

The February issue of HR Magazine hit the nail on the head with Haley Rushing's article, "Managing with the Power of Purpose." The central theme of the article suggests that a successful career and a successful business begin with a sense of purpose for what the employees are doing. Yes, the goal of any business is to make money. However, unless the employee working for that business believes in what they are doing, and are inspired by the goals and objectives of the business, the profit will not come.

Elder Care Guides is proud of our mission statement, which centers on bringing purpose to our clients and employees:

We better the lives of elders in San Diego County living with functional impairments by providing professional care management services that center on the goals of the individual, and foster within the elder a lifelong sense of purpose. We believe that:

• by cultivating every client’s unique sense of purpose, we help them develop a meaningful elderhood with a high quality of life.
• by identifying and reinforcing the strengths of our clients, we promote the development of healthy relationships of interdependence amongst the elder, their family, and other supports.
• our employees are fundamental to our success, and their full engagement enhances the services we provide.
• professional caregivers who are employed by an agency and work as a team with a geriatric care manager deliver the best outcomes for our clients.
• the standards and ethics of the National Association of Professional Geriatric Care Managers provide a solid foundation for our clinical and business practices.

Defining a company culture begins with the company's purpose. Key questions the Rushing article posed include:

• Why does the organization exist?
• What difference is the organization making in people's lives?
• What do the employees strive for, and do their goals match the organizations goals?

Employees are an organization's most important clients. Guiding employees to define their own sense of purpose, then showing them how their desires align with the companies mission and vision is the central component of a successful business. Master that connection, and the revenue will follow.

Elder Abuse and Insurance Fraud

Elder abuse comes in many forms and is often accomplished by individuals who ingratiate themselves with their victims. As in any business there are trustworthy professionals and there are those who scam the public. Many elderly have savings that they wish to safely invest for their future needs but they can be swayed by those they trust to give over their savings for investment purposes created by their "friendly" insurance agent. There is an article that was brought to my attention, written by Elizabeth Furnari, Deputy District Attorney - Insurance Fraud Division of the San Diego District Attorney's Office. She points out that being aware of the different types of insurance and annuity scams is the first step in protecting yourself. http://www.sdcda.org/files/conartists.pdf . Also the The California Department of Insurance (CDI) has created a "Senior Insurance Bill of Rights" which provides a list of precautions to take when purchasing any type of insurance policy and the regulations that protect those rights. http://www.insurance.ca.gov.
There is so much information being provided for the protection of the general public but so many times it is ignored or missed altogether. We at Elder Care Guides try to provide this forum as another way to share information and in doing so we can enlighten and hopefully protect someone from becoming a victim.

Working with Registered Dietitians

Many people think of registered dietitians as individuals who work only in school or hospital settings. Did you know that a dietitian can help you improve your overall nutrition; maintain, gain or lose weight; or manage the symptoms of a chronic illness like irritable bowel syndrome or kidney disease? Since many older adults suffer from nutrition problems, including unhealthy weight gain or loss, dietitians are a valuable resource for our clients and their families.

A registered dietitian (RD) is an individual who has at minimum earned a bachelor's degree with coursework that has been approved by the American Dietetic Association (ADA). Specific areas of study include: food and nutrition sciences; sociology; biochemistry; and physiology. An RD student must also complete an approved practice program at a health care facility, community agency or food service company. To become a registered dietitian, one must also pass an examination and seek continuing education credits. According to the ADA, over 50% of Registered Dietitians hold advanced degrees. They may also earn specialized certification in areas such as pediatric nutrition or diabetic care.

What is the difference between a nutritionist and a registered dietitian? Different states have varying requirements regarding who can call themselves a "nutritionist," however, the "RD" credential is a legally protected title that can only be used by practitioners who are authorized by the Commission on Dietetic Registration of the American Dietetic Association.

I recently became aware of the benefits of working with registered dietitians through personal experience as well as with one of my clients. I worked with an RD to obtain and analyze lab results that revealed vitamin deficiencies; determine my Body Mass Index (a reliable indicator of body fat); and create a meal plan to help me reach my nutrition goals. I referred one of my clients to an RD to help address gastrointestinal symptoms including constipation, gas and upset stomach. The dietitian recommended specific foods, as well as nutritional supplements and digestive enzymes to help ease my client's symptoms. She has also provided ongoing education and support to my client and her care team.

To find a registered dietitian near you, and to read more about nutrition and disease prevention, you can go to the website of the American Dietetic Association.

Elder Abuse and Insurance

Elder abuse comes in many forms and is often accomplished by individuals who ingratiate themselves with their victims. As in any business there are trustworthy professionals and there are those who scam the public.

Many elderly have savings that they wish to safely invest for their future needs but they can be swayed by those they trust to give over their savings for investment purposes created by their "friendly" insurance agent.

There is an article that was brought to my attention, written by Elizabeth Furnari, Deputy District Attorney - Insurance Fraud Division of the San Diego District Attorney's Office. She points out that being aware of the different types of insurance and annuity scams is the first step in protecting yourself. http://www.sdcda.org/files/conartists.pdf. Also the The California Department of Insurance (CDI) has created a "Senior Insurance Bill of Rights" which provides a list of precautions to take when purchasing any type of insurance policy and the regulations that protect those rights. http://www.insurance.ca.gov/

There is so much information being provided for the protection of the general public but so many times it is ignored or missed altogether. We at Elder Care Guides try to provide this forum as another way to share information and in doing so we can enlighten and hopefully protect someone from becoming a victim.

Elder Care: An Employee Benefit

Until recently, day care for children and personal illness have been the major recognized reasons employees need to take excessive time off from work. But what about elder care? Here comes that word again, the sandwich generation, where adults are not only caring for their young children, but their aging parents as well. Being pulled in many different directions affects employees health and well-being, which has a negative impact on productivity, motivation, and health care costs to an organization. Additionally, employees who provide elder care contribute to work interruptions, and unpaid leave. Experts estimate 60% of Americans providing care for someone 50 or older are employed.

Federal law mandates a leave to care for an ill family member, known as the Family Medical Leave Act, and employers are now looking at elder care benefits as a retention tool, in preparation for economic recovery and the accompanying employee turnover expected over the next few years. Many companies have employee assistance programs, which now include more elder care friendly options, such as help with legal and financial issues related to elder care, medical decision support, and even geriatric care management assistance.

Other retention strategies that encompass elder care are those more commonly thought of for child care, but make the transition easily. These strategies include flexible scheduling, paid personal leave days, telecommuting, and job sharing. So, if you find yourself struggling to balance work and elder care, suggest some of these options to your employer, and stress the benefits to the business they will bring. If your employer values retention and high employee morale, these options should be strongly considered.

Caregiver Retention and Turnover: Are You Ready for the Recession Rebound?

The caregiving profession is notorious for turnover. The nature of the business dictates it, and human resource professionals hear every day "I need to work." Although we do our best to keep good employees with as much work as they'd like, it isn't always possible. Due to the recession, however, caregivers have stayed with their employers as active, steady clients have been few and far between for all home care companies. The total employee turnover rate in the U.S. was 16% in 2007, and only 8% in 2009.

The economy is going to recover though. Economists predict a slow, steady recovery, and we have already seen signs of hope. The last piece to regain strength will be employment, but employers need to get ready. Two-thirds of U.S. employees are expected to turnover as the recession deminishes, and that number is even greater for professional caregivers. All those caregivers who have been faithfully sticking by their employers, will start looking elsewhere if they can't get a steady case. Do you want to keep your key employees? What can you be doing to ensure good caregivers don't seek employment at the agency down the street?

We have spoken in this blog before about employee engagement and satisfaction. It's time to start developing a company culture that makes caregivers want to stay, because the economic impact of losing solid, top employee is too great. The most successful retention strategies encompass many factors, including employee engagement, high employer communication, and decentralized management involvement. When employees hear consistent and constant feedback from all levels of the organization, it creates a high sense of belonging and in turn, reduces the desire to seek employment elsewhere. Do your employees know what the company mission and vision is? Are you soliciting ideas from your caregivers on how they can help the growth of the company? We have all heard of exit interviews, but how about STAY interviews?

Employee retention and turnover is a process, not an event. Making sure employees know how essential they are in the success of the business will undoubtedly make them feel valued. Caregivers who are treated as professionals and feel valued and a senses of belonging are the ones that will stay.

National Flu Vaccination Week

January 10th - 16th has been declared National Flu Vaccination Week. The Department of Health and Human Services has reported that in 2009 there were:

• 47 million cases of H1N1
• 200,000 hospitalizations
• nearly 10,000 deaths

Thankfully, the number of flu cases has declined in recent weeks, however experts warn we should get ready for a third wave of H1N1. National Flu Vaccination Week was named to remind Americans to get vaccinated. Vaccinations are now open to everyone in most parts of the country. You can find more information here.

In San Diego county, US Healthworks Medical Group clinics are now offering flu vaccinations for $15. We encourage you to use the link above to learn more about patient eligibility and find the clinic nearest you. If you have your own doctor and insurance, inquire about a special rate for flu vaccinations this week and take charge of your health!