Wednesday, March 2, 2016


We understand that getting better is your top priority. Here at Jamie’s Home Care Services, you can count on us to do your tasks around the house while you focus on getting back on your feet.

Our homemaking/housekeeping services include:
Wash dishes
Take out the trash
Iron clothes
Change linens
Make the bed
Answer the phone
Sort & assist in reading mail
Answer the door
Clip coupons
Shop for gifts
Pet care
Write letters
Check food freshness
Grocery shop
Care for houseplants
Pick up prescriptions

If you would like to meet with us for a consultation and/or assessment, please give us a call at 802-526-4387. You can also send us a message through our Contact Us page on our Website

Saturday, November 7, 2015

Long Term Care / Eldercare Financial Planning: Public and Private Assistance

For Quality Care Let Jamie's Home Care Services Do there Share Contact us for the perfect solution to your home care us today at  802-526-4387 or visit us on the web

Long Term Care / Eldercare Financial Planning: Public and Private Assistance

Page Reviewed / Updated - Apr. 2015
Planning for the financial aspects of long term care is complicated and finding professional assistance is a smart approach. There are both public agencies and private organizations that offer assistance at no charge.  In addition, there are private advisors that charge hourly or project fees for their assistance.
The table below details each type of assistance available, when and for whom they are appropriate, their associated costs and the pros and cons of working with each.

If you require help finding affordable home or residential care, please visit our Finding Affordable Elder Care page.

DescriptionCostPros & ConsMore Information
Resource Locator Tool
Online tool that helps families identify relevant local, state, national and private assistance programs

Free-Fast, free and simple to use
-Cannot resolve conflicting eligibility requirements
-Provides a list of possible options. Users must take the information and develop their own plan.
Use the Eldercare Resource Locator Tool
Social Service Agencies
Area Agencies on Aging (AAAs) help families to identify assistance programs for which they are eligible as well as provide a range of other services
Free-Strong knowledge of local assistance programs
-Less knowledge of national programs and less larger financial planning experience

-Cannot legally advise on qualifying for Medicaid or VA benefits

-Often under-staffed. May have long wait times for appointments
Find your local Area Agency on Aging or read more about the services they provide.
Elder Care Resource Planners
Help families identify all possible financial and other assistance options, determine care cost scenarios and build plans for later life care        
$500 - $1,500-Provide comprehensive view of all possible forms of assistance

-Inexpensive and very thorough

-Provide plans but clients must take action themselves to implement
Learn more or be connected with a Elder Care Resource Planner in your area
Medicaid Planners
Help families, who otherwise would not be eligible for Medicaid, to qualify by restructuring their finances
$2,000 - $5,000 depending on services provided & amount of assets-Focus only on Medicaid; might not be aware of other forms of financial assistance

-Help families preserve their assets
Learn if you're eligible for Medicaid and find help qualifying.
Learn more about how Medicaid planning works.
Geriatric Care Managers
Primarily retained to manage the care of a loved one, some care managers also provide assistance on the financial planning side.        
$50 - $200 / per hour- Very knowledgeable about care needs, local cost of care and care providers

- Typically nursing or social work background not financial planners

- Care management and financial guidance services are bundled
Search our database of geriatric care managers with financial expertise or search the national association's database of managers though not necessarily with financial planning expertise.

Veterans Benefits Advisors
Help veterans understand benefits, eligibility and to assist them in preparing documents and finances for application.       

Free - $2,500 depending on services provided.-Can reduce time required to apply for and therefore to receive benefits

-Greatly increase chance of being approved

-Legally cannot charge for application preparation but can for planning help
-Focused only on veterans benefits, might not be aware of other financial assistance
Learn more about how Veterans Benefits Planner work or find a benefits planner now.
Financial Planners
Trained and certified professionals help families with financial assets to prepare for aging and long term care  
 $2,500 - $5,000+-Focused on middle and higher income families

-Lack knowledge of local and low income assistance programs

-Can preserve assets for future generations

-Can be expensive
Learn more or be connected with a Financial Planner in your area.

Home Care Financial Assistance and Payment Options

For Quality Care Let Jamie's Home Care Services Do there Share Contact us for the perfect solution to your home care us today at  802-526-4387 or visit us on the web @

Home Care vs. Home Health Care
Prior to a discussion of home care payment options, it is helpful to differentiate between home care and home health care. Home Care Aides provide custodial care; they help seniors with their activities of daily living such as bathing, dressing, housekeeping and transportation.  This is also referred to as personal care, attendant care, non-medical care and companion care.
Home Health Aides offer skilled care such as checking patients’ pulses, temperature or respiration. They assist with medications, braces, ventilators and other medical equipment and can provide higher level skilled nursing as well as more basic personal care.  Home health aides are also referred to as nurse aides, nursing assistants, certified nursing assistants and geriatric aides.

Costs: Home, Home Health & Alzheimer's Care
Both home care aides and home health aides bill on an hourly basis (with the exception of live in caregivers who sometime bill flat rates).  Home care aides can be retained through a home care agency or by hiring private caregivers. Home health aides experience greater federal regulation and are almost always hired through an agency.

Hourly rates for home care vary by as much as 50% even in the same state or town.

Nationwide in 2015, the average cost for non-medical home care is $20 per hour with the state averages ranging from $15 - $26 per hour.  It should be noted that these are average costs from home care agencies.  Private individuals can be retained to provide most of the same services with fees that are 20% - 30% lower.  However, these independents are typically uninsured, do not go through background checks and may be unable to provide alternatives in case they are not available to work on short notice.

Independent caregivers typically charge 20% - 30% less than home care agencies.

Home health aides visit the home as much as medically necessary; typically for shorter periods of time than home care aides.  In 2015, nationwide, the average hourly fee is also $20, the same as for non-medical home care.  However, when looking at different state averages there is $16 - $27.
Alzheimer's care at home can be affordable and relatively low cost when compared to residential care. Typically home care providers do not charge additional fees to care for individuals with Alzheimer's. This is not the case in senior living residences where Alzheimer's and dementia care usually costs an additional $1,150 per month.

Financial Assistance for Home Care

Medicare's Benefits

Medicare does not pay for home care aides and only selectively covers home health care.

Home care aides provide personal care rather than medical care and therefore Medicare does not cover the cost of home care.  Medicare Supplemental Insurances cover Medicare co-payments and deductible but do not add new areas of coverage, therefore these policies are of no assistance for non-medical home care.
Home health care costs, on the other hand, are considered medically necessary and therefore they are covered, at least in part, by Medicare and other health insurance programs.  However, Medicare severely restricts coverage to only those individuals who are not able to leave their homes and Medicare will not pay for personal care during the visits, so the visits tend to be very brief and procedural in nature.  Furthermore, the Centers for Medicare & Medicaid Services have announced annual 3.5% reduction in home health care provider reimbursements annually until 2017, which will further impact seniors.
The exception to the limited home care rule are Medicare PACE programs, however these are available only in limited geographic areas.

Medicaid, an insurance program for low income seniors, does pay for home health, non-medical home care and other in-home supports to help the elderly remain living in their homes.  However, Medicaid rules are state-specific and Medicaid covers these services mostly through Home and Community Based Services (HCBS) Waivers.  HCBS Waivers are different in every state, they offer different benefits, having varying eligibility requirements and unfortunately are not entitlements.  Medicaid HCBS Waivers have enrollment caps and waiting lists may exists.  Click here for a state by state guide to which HCBS Waivers cover home care, their eligibility requirements and application processes.
Some home care is also offered through Medicaid Personal or Attendant Care programs.  Again these programs are state specific and can be found at the link above.

Help for Veterans
There are several forms of assistance from the Department of Veterans Affairs that help veterans afford home care.  This may be direct financial assistance or care services that can reduce a veteran's overall need.
To start, there are three different pension benefits which can be applied towards home care.  Individuals who require more care are eligible for higher benefit amounts.  These are the Improved Pension, Homebound and Aid and Attendance.  Eligibility requirements and benefit amounts are available here.  Veterans can also get care assistance through Veterans-Directed HCBS, a relatively new program that allow for self-direction of services and the VA Respite Care which can reduce the home care hours a veteran requires.

State Non-Medicaid Programs
Most states have in-home assistance programs for low income seniors who are not eligible for Medicaid.  These programs are intended to prevent or delay the placement of needy individuals in nursing homes and are loosely referred to as "nursing home diversion programs".    Eligibility, benefits and even sources of funding varies with each program and some states even have more than one program.  As an example of the diversity, some of these programs provide cash assistance, others provide care services and respite and still others provide non-care based, in-home support such as assistance with chores, meals and transportation.  Assistance with adult day care and assistance for home modifications to enable aging in place are two other approaches the states use to help.  The common thread amongst all of these programs is that they help seniors remain living at home or help families to care seniors in their homes.
Please follows the links below to read about specific programs in your state.

State Non-Medicaid Home Care Financial Assistance Programs 
Arizona NMHCBSNebraska Lifespan Respite
Alaska Senior BenefitsNebraska Social Services for Aged and Disabled Adults
Alaska Senior Access ProgramNebraska Disabled Persons and Family Support
Alaska Adult Day Services
Alaska Alzheimer’s Mini-Grants
Nebraska Assistance to the Aged, Blind, or Disabled
Alaska Senior In-Home ServicesNevada COPE
California Alzheimer's Day CareNevada Homemaker Program
Nevada Personal Assistance Services
California In-Home Supportive ServicesNew Hampshire Transitions in Caregiving
Colorado Old Age PensionNew Jersey Alzheimer's Adult Day Care
Colorado Home Care AllowanceNew Jersey Statewide Respite Care
Connecticut CHCPE
Connecticut Adult Family Living / Caregiver Homes
Connecticut Choices at Home Project
New Jersey Assistance for Community Caregiving

New Mexico Older Americans Act Services
Delaware Adult Day Care and Alzheimer's Day Treatment New York Expanded EISEP Program

New York Community Services for the Elderly
CARE DelawareNorth Carolina In Home Aide Services
DC's Senior Citizens' Home RepairNorth Carolina Project C.A.R.E.
Florida OSS for SeniorsNorth Dakota Older Americans Act Services
Florida Project R.E.L.I.E.F.North Dakota SPED and Ex-SPED

Ohio Older American Act Services
Florida Alzheimer’s Disease InitiativeOklahoma Respite Resource
Florida CCE ProgramOklahoma Adult Day Care Services
Florida Home Care for the ElderlyOklahoma In Home Assistance Services for the Elderly
Florida Local Services ProgramOregon Project Independence
Georgia Home & Community Based ServicesPennsylvania Options Program
Hawaii Kupuna CareRhode Island Home and Community Care Co-Pay Program

SC Older Americans Act Services
Hawaii Chore Services ProgramSouth Dakota Homemaker, Chore and Respite Care Programs
Idaho Senior RespiteTennessee OPTIONS for Community Living
Idaho Homemaker ServicesTexas CCAD Program
Illinois Community CareTexas Community Attendant Services
Indiana ChoiceTexas DADS Services to Assist Independent Living
Iowa Able Foundation Loan ProgramTexas In-Home and Family Support Program
Tennessee Homemaker / Adult Day Care
Iowa Senior Living - Case Management ProgramUtah The Alternatives Program
Kansas Senior Care ActVermont Dementia Care Respite
Vermont Home Sharing Program
Kentucky Hart-Supported LivingVirginia Adult Services
Kentucky Personal Care AttendantWashington Volunteer Chore Services
Kentucky Adult Day Care and Alzheimer's RespiteWest Virginia Ron Yost Program
Maine Home-Based CareWest Virginia In Home Services for the Elderly
Maryland Senior Care ProgramWest Virginia Family Alzheimer’s In-Home
Maryland In Home-Aide ServicesWest Virginia Lighthouse Program
Massachusetts HCP and ECOP ProgramsWisconsin SSI Exceptional Expense Supplement
Minnesota Alternative Care Program

Minnesota Essential Community Supports
Wisconsin Community Options Program
Mississippi In Home Care Services / Homemaker ProgramWisconsin Alzheimer's Family & Caregiver Support
Wisconsin Family Care and Partnership
Wyoming Home Services Program

Other Options
Families should think not just about programs which offer assistance but also programs targeting seniors that can reduce other expenses thereby freeing up financial resources to put be towards the cost of home care.  In this category there are a variety of tax credits and deductions.  For example, any expense incurred to care for an elderly relative that enables the family to work is tax deductible. Read about other tax credits for elderly.

Home care and adult day care are, in most cases, tax deductible expenses.

Energy costs to heat and cool one's home can take up a significant portion of low income seniors' fixed incomes. LIHEAP is a program designed to help seniors with their home energy bills, which can again free up dollars for home care.  The LIHEAP application has specific filing deadlines which often give preference to lower income seniors. Learn more here.

Non-profit organizations sometimes offer financial or care assistance for individuals with specific conditions.  Explore programs at the following  links for individuals with Alzheimer’s , Cancer, Diabetes , Kidney Disease and Leukemia .

Possibly the easiest and most effective way to reduce home care expenses is to find affordable care.  The hourly rates for home care can vary by as much as 50% even in the same geographic area.  Our organization provides a free service that help families to locate quality-screened, affordable care providers.  Start here.

Self-Payment Options for Home Care

Reverse Mortgages / HELOCs / Equity Key
There are several ways families can self-pay for care by using their home as a financial resource, these include reverse mortgages, home equity lines of credit and Rex Agreements.  However, depending on marital status, severity of need and the projected length of need not each of these options necessarily makes economic sense.  For example, if the person in need of care is single and may need to move into residential care within a two year period, then a reverse mortgage is probably not the best option.   The same applies to Rex Agreements.  One can read more about when it is best to use each of these options and their pros & cons at the following links: Reverse Mortgages, Home Equity Lines of Credit, Rex Agreements.

Life Insurance Policy Conversions
Life insurances holders have a variety of ways of converting their policy into cash or home care services prior to the policyholder's passing.  There are three options that allow individuals to stop making premium payments and receive immediate payouts on their policies without passing.  Viatical settlements are designed for individuals with less than 2 year life expectancy.  Life settlements are intended for persons with longer life expectancies.  Life insurance conversions give consumer the greatest value for their life insurance policy however the benefit comes in the form of care services instead of cash.  Pros, cons and eligibility information is available for viaticals, life settlements and conversion programs.

 Life insurance policies can be converted into home care services, preserving the policyholder's eligibility for Medicaid.  Learn more.

Accelerated death benefits and death benefit loans are two other ways individuals can receive cash for the life insurance in advance of their death.  However, with these two options, the policyholder must continue to make their monthly premium payments.

Home Care Loans
Loans specifically designed for elder care are a new and interesting financial product.  These loans are intended for short term needs while a family is waiting for other financing.  For example, a veteran's pension claim approval can take 6-12 month, but once it is approved, it is paid in a retroactive lump sum back to their claim filing date.  A loan is made to these individuals with the expectation that it will be re-paid for the lump sum.  A similar situation exists for families selling a home and having the elderly relative move in with the adult children.  Finances will become available it is just a matter of when the home will sell.  For more information on fees, pros and cons for home care loans, click here.

Long Term Care Insurance
Individuals with long term care insurance can use the benefits to pay for home care.  For persons without LTC insurance who have a need for care, they typically are not eligible to purchase insurance.  For this reason our discussion of LTC insurance is relevant only to persons doing very long term planning.

Finding Affordable Home Care
There is a great deal of variation in the cost of home care not just amongst the states but even in the same geographic area within a state. A recent study found in most areas, there are care providers who charge as much as 50% below or above the average hourly rate for that area. This means the choice of care provider is a major factor in affording long term care at home. It is difficulty and time consuming to contact each care provider in the area and determine their rates. For this reason, we've partnered to provide a free service that helps families find the most affordable home care in their area. Start here.

Developing a Financial Plan for Home Care
Since many families pay for home care from their savings, they are in a state of continuously diminishing resources. Many assistance programs determine eligibility based on an individual’s resources. Therefore, the assistance available to an individual is constantly changing. In other words, the longer a person requires (or is projected to require) home care, the more assistance that becomes available to them.

For this reason (and others), it is advantageous to develop a long term financial plan when considering home care. Doing so has the dual benefit of ensuring a comfortable and consistent aging process for your loved one while at the same time preserving your family’s assets and resources.

The creation of a financial plan for home care is a complicated process and must accommodate various health scenarios. Fortunately, there are resources available to help families with financial planning for home care.  A complete exploration of one's care planning option is available here and summary follows below.  Each option has its pros and cons.
  • Public Benefits Counselors – local Area Agencies on Aging (AAA) and Aging and Disability Resource Centers (ADRC) have benefits counselors on staff that can help with financial planning. While they typically do not charge for their assistance, they may be under-staffed and unable to provide adequate long term planning. They also tend to be highly knowledgeable about local programs but have less larger financial planning experience.  Find your local AAA or ADRC.
  • Geriatric Care Managers – GCMs help families create and implement long term care plans and, as a part of that, some will help with financial planning. Since GCMs are typically paid for out-of-pocket, one can expect a higher level of attention than one might receive from a public benefits counselor.  Families tend to contact GCMs only after the need for care has become apparent and therefore GCMs are not in the best position to do long term planning.  Often GCMs come from nursing or public health backgrounds and do not have extension financial experience.  Find a Geriatric Care Manager.
  • Eldercare Resource Planners - ERPs are specialists in developing financial plans for home care.  They differ from Care Managers in that they typically come from a financial background instead of healthcare background.  They are paid out-of-pocket but can often pay for themselves in the financial assistance resources they discover for their clients.  They are significantly less expensive than Elderlaw attorneys, but cannot perform some of the legal procedures which only attorneys can.  Learn more.
  • Elderlaw Attorneys - the most expensive and most thorough option.  An elderlaw attorney and their staff can provide a one-stop shop for home care financial planning but their hourly rate may prove cost-prohibitive for some families.  One can search the National Academy of Elder Law Attorney database here.

State-by-State Home Care Costs and Affordability Index
This table contains the average hourly cost of home care aides for all 50 states and D.C. In addition, it contains our experimental home care affordability index* which considers the cost of home care in a state relative to its median household income. The state’s ranking out of 50 states and Washington D.C. is contained in the final column.

2015 Home Care Costs and Affordability
Home Care Hourly Rate
Home Care Affordability Index.
Lower #s are more affordable.
State Index Ranking
United States
District of Columbia
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Rhode Island
South Carolina
South Dakota
West Virginia

*Data provided by Genworth Financial, Inc. (NYSE:GNW) and the US Census Bureau

Tuesday, August 18, 2015

Respect Outweighs Wages for Home Health Worker Satisfaction

heath workers report higher levels of satisfaction with their jobs when they feel respected and valued by their superiors and the agency as a whole, while hourly wage doesn’t necessarily denote workplace satisfaction, according to a survey analysis published late last week.
The research aims to pinpoint factors that influence a home health worker’s job satisfaction and whether they affect his or her decision to resign. Its analysis was authored by Social & Scientific Systems, Inc. in conjunction with provider association LeadingAge.
Specifically, the analysis hones in on the extent to which compensation positively correlates with job satisfaction and negatively correlates with intent to leave; how job stressors or demands associate with job satisfaction and result in intent to leave; and the ways a supportive workplace leads to job satisfaction and lessens an employee’s intent to leave.
“It is critical to address workforce retention because these problems will probably be exacerbated in the future,” the report stated. “Understanding the determinants of turnover will help policymakers, agencies, workers, clients and their families to modify, to the extent possible, specific policy-level, workplace-level and worker-level factors that will support a more stable, quality home health workforce.”
Overall, the report indicates that home health workers who are dissatisfied with their jobs have greater intentions to leave. This held particularly true when considering agency structure and policy, as workers employed by for-profit chain-owned agencies are more than twice as likely to intend to leave their jobs as those working for non-profit or other organizations.
Analysis of the research finds that supervisors who show respect for home health workers and organizations that value their employees significantly impact overall job satisfaction. While this might seem obvious, some other findings are less intuitive: The report also suggests those with higher wages have lesser odds of being extremely satisfied with their work.
Another indicator of home health worker satisfaction is a work environment where employees are encouraged to discuss patient care with family, according to the report.

Jamie's Home Care Services
3049 Cleveland Ave Suite 276
Fort MyersFL 33901

Written by Kourtney Liepelt

NAHC President Optimistic About Face-to-Face Ruling

The leader of the National Association for Home Care & Hospice (NAHC) is in a positive frame of mind following recent oral arguments in the organization’s lawsuitagainst the federal Medicare agency over the so-called “face-to-face” rule.
If NAHC succeeds in pressing its case, home health agencies may be paid a large portion of the $200 million to $250 million in claims that currently are in “limbo,” NAHC President Val J. Halamandaris tells Home Health Care News.
“I think the odds of our winning are very, very good indeed,” Halamandaris says, with the caveat that sometimes judges can issue surprising decisions. U.S. District Court Judge Christopher R. Cooper heard oral arguments in the case on Aug. 6.
Some of Halamandaris’ confidence is rooted in the success NAHC already has had—the association mounted a challenge that got the face-to-face rule’s “narrative requirement” struck down. This was a mandate that physicians not only had to see patients and certify that they were homebound, but provide detailed reasons why as well.
Imposing this requirement exceeded the Centers for Medicare & Medicaid Services’ (CMS) statutory authority, NAHC successfully argued. However, CMS only did away with the narrative requirement prospectively, meaning that a significant number of claims remained unpaid for the period between 2011 and 2014 when the requirement was in effect.
“There needs to be an adjudication of each of these claims on the merits, each one, and we feel confident that most will be paid, the great majority,” Halamandaris says. “That’s what we’re fighting for, the fair treatment on the part of people who went out and delivered that care. They shouldn’t be left in limbo … CMS has never said in absolute terms that the claims are being denied.”
Judge Cooper appeared to be sympathetic to the NAHC arguments, Halamandaris says. The judge had sharp questions for the CMS legal team, according to Halamandaris, and he does not believe the lawyers for the government were able to put together a persuasive case.
CMS does have one thing working in its favor, Halamandaris says: The fact that courts generally like to give agencies the benefit of the doubt when it comes to how they implement regulations. But in this case, it appears clear that CMS itself realizes that the narrative requirement was “inappropriate if not illegal,” the NAHC leader says.
While there is no precise timeline for a ruling, one should be forthcoming in the next few months, perhaps as early as September, Halamandaris says.

Jamie's Home Care Services
3049 Cleveland Ave Suite 276
Fort MyersFL 33901

Thursday, August 13, 2015

Whats ok and whats not ok when you are a caregiver

What’s OK and What’s Not OK When You Are a Caregiver
By Cindy Laverty 
Everywhere I travel and meet caregivers, I see a common theme: Most family caregivers are afraid to ask for help. Somehow people think that they should just miraculously know how to care for an aging loved one.
Why would you know this? You did not receive PhD in Caregiving and your loved one poses challenges that you don't have the answers to. As I'm listening to their challenges, frustrations, fears, sorrows, stress-induced situations and overall feelings of being overwhelmed, I find that many caregivers seem to need permission from a professional to ask for help. So very simply, I reach out and take the person's hand, and give permission. Usually there is an instant look of relief in the person's face. It's incredible that giving someone permission to not be perfect helps relieve the pressure and the stress.
Caregivers frequently suffer from severelystressful emotions that can control and even ruin their lives. Sadly, these are the caregivers who, for whatever reason, have refused to ask for help or seek professional advice either from a medical doctor or a therapist. In order to manage the caregiving journey, you simply must step out of your comfort zone and find alternative methods for dealing with your personal situation.
The only way that family caregivers can sustain all that needs to be done to care for a loved one is to delegate responsibility and ask for help. It's really simple and it changes lives.
Here are some things that I think are okay for caregivers:
It's okay to be scared.It's okay to be angry, lost, sad and evendepressed.It's okay to lose your patience.It's okay that you don't want to sacrifice your whole life for someone else. And you shouldn't.It's okay that your self-esteem feels damaged.It's okay that you make mistakes.It's okay that you don't know how to do everything.It's okay that you don't have the answers.It's okay that you don't have a cure.It's okay that you're not there all the time.It's okay that you sometimes have extreme feelings towards the person for whom you are caring.It's okay that you lost your temper.It's okay that you had to apologize.It's okay that you're afraid.It's okay that you can't get everything done in a day.It's okay that you have guilt. All caregivers have guilt.It's okay that you have compassion fatigue.It's okay you feel trapped.It's okay that you took a few days for yourself.It's okay that you vented to your spouse or friend.
All of these things are absolutely okay. How you manage them is going to make the difference between becoming an Empowered Caregiver or staying in a hopeless situation.
Here are some things that are NOT okay.
It's not okay that you feel like you have to do everything yourself.It's not okay that you feel like an indentured servant.It's not okay that you are ignoring your personal needs.It's not okay that you are ignoring friends and social activities.It's not okay that asking for help paralyzes you.It's not okay that you don't have a plan in place.It's not okay to feel helpless and hopeless for days on end.It's not okay that you have stopped doing activities you once loved.It's not okay that you are afraid to say "no" or "not now."It's not okay that your siblings don't help you.It's not okay that you don't have boundaries in place.It's not okay that you feel unappreciated by your family.It's not okay that you have lost pride in what you are doing for another human being.It's not okay to sacrifice your financial security.It's not okay that you do everything your loved one wants, especially when the demands can be outrageous.It's not okay that you don't sleep or eat properly.It's not okay that you are constantly exhausted when help is available, if you would only seek it.It's not okay that you are sacrificing your personal health for another.It's not okay that you are constantly trying to fix everything that is wrong.It's not okay that you are living your life in crisis.
If any of the above rings true for you, then decide right now that you will get the help you need. Decide that you will live your life in a better way. Decide that you will take the necessary steps to ask for and get answers to the challenges that you are facing. Decide today that you are worth the time, energy and financial investment to survive, thrive and become an Empowered Caregiver

Jamie's Home Care Services
3049 Cleveland Ave Suite 276
Fort MyersFL 33901

Wednesday, August 12, 2015

Vascular Dementia

What is vascular dementia?

Vascular dementia (VaD), also called multi-infarct dementia, occurs when the cells in the brain are deprived of oxygen. A network of blood vessels called the vascular system supplies the brain with oxygen. If there is a blockage in the vascular system, or if it is diseased, blood is prevented from reaching the brain. As a result, cells in the brain die, leading to the symptoms of dementia. After Alzheimer's disease, VaD is the second leading form of dementia, accounting for up to 20% of all cases.

When Alzheimer's disease and VaD occur at the same time, the condition is called "mixed dementia".

How does vascular dementia affect the person?

Stroke and vascular dementia

Stroke is a common cause of VaD. A stroke occurs when blood flow in the brain is blocked or a blood vessel bleeds, preventing the blood from flowing properly through the vessel. When this happens, the brain cells cannot get oxygen and they die. Strokes can be large or small, and can have a cumulative effect, which means each stroke adds more to the problem. Strokes can affect how a person can walk, and cause weakness in an arm or leg, slurred speech or emotional outbursts. The difficulties the person has depend on the part of the brain that did not get the oxygen.

Vascular dementia usually comes on suddenly. Difficulties may happen in steps. Sometimes, the person’s abilities may deteriorate for a while and then stand still for a time. Then, they may deteriorate again. The cognitive symptoms, the ability to think, may change, affecting some areas of the brain more or less than others (e.g., the areas that control language, vision or memory). Urinary difficulties (difficulty going to the bathroom) are common in people who have VaD.

Binswanger's disease

Binswanger's disease is a rare form of VaD that is caused by damage to blood vessels deep in the brain's "white matter." High blood pressure plays an important role in Binswanger's disease.

How is vascular dementia assessed?

If VaD is suspected, the doctor will often order scans of the brain in order to check for blockages or narrowing of blood vessels in the brain.

What are the risk factors for vascular dementia?

Both men and women can be affected by vascular dementia. Risk factors include:

Being older than 65Having high blood pressure (hypertension)Having heart diseaseHaving diabetes

Smoking, being overweight, having high cholesterol levels and having a family history of heart problems may also increase the risk of having stroke, which increases the risk of vascular dementia. Mini-strokes (sometimes called transient ischemic attacks or TIAs) are warning signs that a stroke may come. Losing vision, speech or strength temporarily, or having short episodes of numbness may mean someone is having a TIA.

Routine brain scans in a group of middle-aged people showed that 10 per cent of them had had a stroke but did not know about it. Having the stroke, even if they did not know, raised their risk for more strokes and memory loss. These silent cerebral infarctions (SCIs, or silent strokes) are caused by a blood clot that blocks the blood flow to the brain. Many times, silent strokes are considered to make up a risk factor for vascular dementia. People with atrial fibrillation, the most common type of irregular heart beat in people over 65, have more than twice the normal rate of these silent strokes.

Knowing the risk factors for vascular dementia is important because often they may be treated, to reduce the risk of having a stroke. Risk factors can be reduced by adopting a healthy lifestyle that includes regular physical activity, eating well, avoiding smoking and reducing stress. Medications can control high blood pressure, diabetes and heart disease.

Is there treatment?

After a person has a stroke, medication may be prescribed to improve blood flow to the brain and reduce the risk of further stroke. A person may also benefit from different therapies to help with movement and speech, such as physiotherapy, occupational therapy or speech therapy. Aside from the treatment of the underlying causes of vascular dementia such as hypertension, high cholesterol and diabetes, some physicians routinely recommend the use of medications called cholinesterase inhibitors.

For more information:

Call your local Alzheimer Society or visit the We Can Help section of our website.Visit the Heart and Stroke Foundation website Mayo clinic Alzheimer's Society (UK); "Understanding Vascular Dementia"Webinar on vascular dementia presented by the Canadian Dementia Resource and Knowledge Exchange (CDRAKE)

[The contents of this document are provided for information purposes only, and do not represent advice, an endorsement or a recommendation, with respect to any product, serve or enterprise, and/or the claims and properties thereof, by the Alzheimer Society of Canada. The Information Sheet is not intended to replace clinical diagnosis by a health professional.]

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