Millions Manage their Aging Parent’s Care Cross Country- are You Among the Ranks?

If you are a long-distance caregiver who is managing your aging parents’ healthcare from afar, you may be experiencing the same stress and anxiety as millions of other Americans. According to an article by the Associated Press, approximately 7 million Americans are long-distance caregivers. The term caregiver refers to anyone who provides assistance to someone else who is, to some degree, incapacitated and needs help performing the daily tasks essential to living a normal life. This includes many conditions, but among them-  someone who has suffered a stroke or has Parkinson’s disease, Alzheimer’s disease, cancer, a traumatic brain injury, heart disease, mobility impairment or an elder who is simply frail.

Family caregiver statistics

Many times, a caregiver is an unpaid family member who is involved in assisting a parent unable to perform certain activities on their own.According to the National Caregiver Alliance,

  • The average caregiver is age 46, female, married and working outside the home earning an annual income of $35,000.
  • Although men also provide assistance, female caregivers may spend as much as 50% more time providing care than male caregivers.

Long-distance caregivers all report roughly the same dilemma: managing doctor’s appointments and medications, coordinating between healthcare providers, and overseeing insurance and a parents’ overall well-being is nothing short of daunting. It often compromises a caregiver’s family obligations, career and overall quality of life. Many caregivers would prefer to live within closer proximity of their parents, but it is simply not an option. Economic factors often drive people far from their hometowns; we take jobs where we can get them!

A typical scenario of long-distance caregiving:

Kristy Bryner lives in Portland, Oregon and cares for her 80-year-old mom in Kent, Ohio.  She’s worried that her mother may slip and fall, miss her medications or have a medical emergency with no one there to help. Bryner reminds her mom to take her medicine, makes sure rides are lined up for doctor’s appointments, deals with problems with insurance coverage or financial issues and rushes to her aid if there’s a problem. Bryner knows her mom wants to stay in her home, but says someone needs to look out for her. That’s why Bryner talks daily with her mother via Skype. Many long-distance caregivers say they insist on daily calls or video chats to check up on their loved one. Often, they need to find another relative or paid caregiver who is closer and can help with some tasks.

Expenses of long-distance caregiving

Long-distance caregiving is expensive in and of itself. Whether it’s paying for prescription medications or doctor co-pays, installing a ramp for a wheelchair-bound parent, or purchasing other supplies, caregiving has a significant economic impact on a family. A 2007 report by the National Alliance for Caregiving and Evercare found that annual expenses incurred by long-distance caregivers averaged about $8,728—far more than caregivers who loved close to their loved one.

Over the next four decades, the number of people 65 and older is expected to rapidly expand. The result will be a far smaller share of people between 20 and 64—the age groups that most often is faced with caregiving.

Local caregivers under the gun

It’s not just the long-distance caregivers that are under pressure. Family members who live locally and are caring for a loved one can be the most overwhelmed! Often, because of their proximity, they are the sibling who’s expected to do everything for mom or dad- even when they have family and career responsibilities of their own. Local caregivers may not feel comfortable making all of the medical decisions alone and the hours required on a weekly basis may be more than their job allows. Many caregivers report losing jobs and/or a work demotion due to lost hours and taking leaves of absence from work.

What is a Private Healthcare Advocate & why do you need one?

What does that mean for those of us who have aging parents and are anticipating various forms of caregiving in the future?  A plan for the future is a great start! It’s not enough to hope for the best or leave it up to chance. One solid solution is a Private Healthcare Advocate. Advocates are health care professionals (such as RNs) who have intimate knowledge of hospitals and our medical system. A private healthcare advocate insures that you always have an expert on hand—and this is set up BEFORE you are in “crisis mode.” Advocates will help and guide you with all aspects of your aging parents’ healthcare needs—and you don’t have to worry, because they are experts. Here are the services that a private healthcare advocate will provide for your parent or loved one:

ü  Healthcare Planning: Develop a personal care plan: short-term & long-term.

ü  Unexpected Medical Events: They will help & guide you in an unforeseen medical event in order to make the best possible decisions.

ü  Research all Treatment Options Available: Help locate the best care and/or facilities. There are specific facilities for different types of necessary care.

ü  Act as a Liaison with Healthcare Providers:  Ensure they are communicating well.

ü  Resources: Advise you about your insurance and/or Medicare coverage. Need community financial aid? They can help you locate and secure it.

ü  Medical Bills: Review & negotiate for you.

ü  Home Visits: If the caregiver is long distance, many advocates will make periodic visits to ensure the patient is receiving the proper care and taking their medications.


California & Washington Residents: Contact Mid-Valley Legal Nurse Consulting

Get all the details you need about finding a Private Healthcare Advocate. A MVLNC Private Healthcare Advocate will help you navigate our health care system. We can take the added stress away and give you back your quality of life. Managing your loved one’s health & well-being doesn’t have to be complicated! You are still your parent’s caregiver, but now you can add the necessary expertise to make it all manageable. After all, everyone needs to be healthy—including the caregiver!

Give us a call, email any question or  contact MVLNC online to get started.

CA: (559) 862-1224     WA: (360) 450-3590

Posted in Nursing, Patient Advocacy, Patient Navigator, Private Healthcare Advocate, Senior Care Management | Tagged , , , , | 1 Comment

Medical Bills – Ignoring Them Will Not Make Them Go Away

Medical Bills are overwhelming  for most people makes them want to put them in a pile on the desk and deal with them later. However, later never comes and they become more and more complex. One hospitalization can lead to the hospital bill, along with separate bills from the laboratory, radiology, physicians.etc. Then you wait for the insurance to pay, or is it going to pay? If you do not have insurance you wonder if the bills will ever stop.

When presented with medical bills that are overwhelming do not wait to get help. I suggest not to ignore them but seek help with them sooner than later. If they go to collection it is much harder to resolve issues. The financial service office at the hospital or the physician office maybe a first stop in the process. Check and see if they have any special programs for people in your income bracket or with your financial set of circumstances. There will be paperwork to fill out but it may be worth the time and effort it takes to do this. It is possible to negotiate medical bills.

Some Private Health Care Advocates and Certified Life Care Planners offer services that can you with figure out medical bills, insurance payments, or help with filling out the paperwork properly. Ignoring them will not make them go away and will only lead to more stress. If you are looking for help from a Private Health Care Advocate or Certified Life Care Planner here are two websites with directories where you might find some help:

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Broken Compact Flourescent Light Bulb – How to Clean Up

Compact fluorescent light bulbs ( CFL’s) and other fluorescent light bulbs all contain mercury.  CFL’s contain about 3 – 4 milligrams of mercury in a glass tube. As CFL’s use has increased it is important to know how to clean up if one breaks in your home or office.  The following information has been provided by the Environmental Protection Agency: “A Quick Guide to Cleaning Up Broken CFL’s:”

  1. Before cleanup
    • Have people and pets leave the room.
    • Air out the room for 5-10 minutes by opening a window or door to the outdoor environment.
    • Shut off the central forced air heating/air-conditioning system, if you have one.
    • Collect materials needed to clean up broken bulb. Collect materials (stiff paper/cardboard, sticky tape, damp paper towels/wet wipes) needed to clean up broken bulb.  Vacuum cleaners and brooms are not used to clean up mercury spills.
  1. During cleanup
    • Be thorough in collecting broken glass and visible powder.
    • Place cleanup materials in a container and seal. This will be a glass bottle or plastic container.  Remember that these materials cannot be thrown out in the regular trash.  It will be necessary to rid these materials through your local hazard waste program.  Check with your local/county public health department.

After cleanup

  • Promptly place all bulb debris and cleanup materials outdoors in a trash container or protected area until materials are disposed of properly. Remember, this cannot be picked up by your local trash pickup and brought to the landfill.  Avoid leaving any bulb fragments or cleanup materials indoors.  Contact your local health department for Household Hazardous Waste disposal information.
  • Continue to air out the room where the bulb was broken and leave the heating and air conditioning system shut off for several hours.

Additional information on how to safely use and clean up after broken CFL’s is able to be found at the following links:

Click to access CFL_brochure.pdf

If energy conservation is a priority for you and your family and you use CFL’s in your home, be sure to keep these tips available and check Environmental Protection Agency website for ongoing updates.  Reading the packaging materials the CFL’s come in should also be a helpful.

Posted in Patient Advocacy, Public Health Concerns, Uncategorized | Leave a comment

Metabolic Syndrome and the Risk of Heart Disease, Diabetes, and Stroke

Metabolic syndrome is a name given to common risk factors that when at least three are present lead to increase risk of heart disease, diabetes, and stroke. General risk factors that can lead to any of these diseases are: genetics, sedentary lifestyle, obesity, hormonal changes and aging. However the American Heart Association states that you are at risk of metabolic syndrome and increased risk of heart disease, diabetes and stroke if you also have at least three of the following present:

• Blood pressure equal to or higher than 130/85 mmHg
• Fasting blood sugar (glucose) equal to or higher than 100 mg/dL
• Large waist circumference (length around the waist):

  • Men – 40 inches or more
  • Women – 35 inches or more

• Low HDL cholesterol:

  • Men – under 40 mg/dL
  • Women – under 50 mg/dL

• Triglycerides equal to or higher than 150 mg/dL

How can you prevent metabolic syndrome and its risks? First see you physician and get a physical. Your doctor will check your blood pressure and recommend specific blood tests that check if your cholesterol and blood glucose are too high. If your physician prescribes any medications make sure you take them as indicated. Get moving – exercise helps to improve blood glucose, lower cholesterol and maintain optimal weight. Finally eat a healthy diet – fruits, vegetables, whole grains are some of the basics. The America College of Cardiology cites the Mediterranean diet as being beneficial to preventing metabolic syndrome and its other health risk factors: For more information on preventing metabolic syndrome visit the American Heart Association website:

Posted in Clinical Corner, Nursing, Patient Advocacy, Public Health Concerns, Uncategorized | Tagged , , , , , | 1 Comment

Team Semper Fi – Wounded Marines use Sports and Recreation as a Road To Recovery

On March 5, 2011 I rode the 45 mile bike ride known as the Reedley Blossom Ride. This is an annual bike ride help by the Reedley Lion’s Club. The Club uses the proceeds go to help different organizations throughout the year in the local community. This year the blooms were gorgeous and it was a beautiful ride. As we started our ride I was not more than one mile out and looked to my right and there was a retired marine from Team Semper Fi riding along next to me pedaling with his hand-held pedals. Once you ride next to a member of Team Semper Fi you have no choice but to ride your best and not complain about it being the first long ride of the season. Team Semper Fi is an organization that uses sports and recreation to help wounded Marines recover from their injuries. Many had trained to do the 25 mile ride and as peer pressure would have it committed to the 45 mile ride the day of the ride. Team Semper Fi has joined our Community on this ride for the past two years and it is really inspiring to ride with them.

I wanted to take this opportunity to help spread the news about Team Semper Fi and the Semper Fi Fund:

Semper Fi Fund (SFF)

The Injured Marine Semper Fi Fund is a 501(c)(3) nonprofit set up to give immediate financial support for injured and critically ill members of the U.S. Armed Forces and their families. American heroes have sacrificed; they deserve the best care and support available in their hour of need. Injuries are often severe, and the road to recovery or rehabilitation is long and costly. SFF provides support in many ways including: Service Member and Family Support, Specialized & Adaptive Equipment, Adaptive Housing, Adaptive Transportation, Education and Career Transition Assistance, Therapeutic Arts and Team Semper Fi (TSF).

Team Semper Fi (TSF)
Injured Marines make up the core members of Team Semper Fi. SFF’s goal for Team Semper Fi is to give encouragement, motivation, and individual goals through sports. SFF provides coaches, specialized sporting equipment, team uniforms, entry fees, and travel expenses for the injured team members to compete in events across the country.
Made up of more than 200 service members who qualify for our help, Team Semper Fi (TSF) is the heart and inspiration of the Semper Fi Fund’s (SFF) rehabilitative Athletic Program, and is an extension of the help they give. TSF members also are receive Olympic training through their partnership with The US Paralympic Military Program.

The camaraderie, the inspiration, the courage behind this team is truly extraordinary!!

To show your financial support for this organization, please visit them online at

Thank you Team Semper Fi for your service.

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FDA Warns Topamax may cause birth defects.

Topamax is a drug physicians prescribe for people with epileptic seizures and migraine headaches. Today the Food and Drug Administration posted a warning. Infants exposed to Topamax in the first trimester had a risk of developing cleft palate and/or cleft lip at a rate three times greater than those exposed to other anti-seizure medications. When an infant has cleft palate/cleft lip parts of the oral cavity do not fuse together. It is hard for the infant to eat and swallow. Poor feeding results in failure to gain weight, poor growth, increase risk of ear infections and other potential health risks. Treatment for this condition is surgery. Women who are pregnant or thinking of becoming pregnant should talk to their doctor if they are being treated with Topamax or their doctor suggests prescribing Topamax. For more information please see the FDA website:

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University of Maryland Baltimore Study shows Nurses Need More Sleep.

A University of Maryland Baltimore Study reports that Nurses sleep an average of 5.5 hours between their 12 hour shifts. The study showed there a correlation between this and errors. I worked night shift for 11 years, most of that time was on 12 hour shifts. I would have to vouch that my average sleep time was 6 hours or less between my shifts. I did not like to work more than 3 12 hours shifts in a row before I believed I felt the effects of being sleep deprived. I have worked with many nurses who would work 4 to 6 12 hour shifts straight to be off more days in a row. As a nurse manager I was always concerned about how many shifts an individual could work and the relation patient safety and the safety of the RN.  Regulations focus toward the number of hours worked in a day vs. how many 12 hour shifts might affect patient safety due to lack of sleep. I personally welcome more studies on this matter with the hopes it will give nurses the information they need to create staffing schedules that do not put their patients at risk, as well as, do not put themselves at risk of an accident while driving to and from work.  Nursing is a science and standards of practice are based off of research studies that develop into best practice.  Continued research on the topic of sleep and  nurse scheduling habits would give nursing information it needs to develop best practices in staff scheduling resulting in fewer patient errors.

Please see that link noted for the full article:

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“Sleep Tight – Don’t Let the Bed Bugs Bite.”

Why did I decide to write about bed bugs? I teach a class on communicable diseases and this has caused me to follow this growing concern in the United States. I also have family members who travel and personally I believe bugs can live as long as they want – outside of my home. I have taken the time to learn about this to do my part and try to prevent spreading these ectoparasites. I might also add it is October, and getting near Halloween so what better time to write about these creepy crawly blood sucking pests.
Many of us grew up hearing our grandparents say “Sleep tight – don’t let the bedbugs bite.” Well for most of us we probably thought this was just one of those things our grandparents said, until now.
Here is some history: bed bugs were a problem in the United States before WWII. With the introduction of pesticide DDT they were pretty much eradicated.  There is an entire generation or more that have  never been exposed to bedbugs – until now. It has become a growing issue in the United States, particularly in populated areas, however entomologists do believe that we should all become aware of bedbugs because they hitchhike so well and it is only a matter of time before other areas and regions become highly populated by these bugs. Entomologist believe the bed bug infestation will get worse before it gets better. Education on bed bugs can prevent or limit the social stigma and help prevent spread of bed bugs. Bedbugs are a growing issue because they have become resistant to our pesticides making it harder to get rid of them. Also we are a global society – this makes it easier to transport them around the world, without notice.
What are bedbugs?
They are small flat oval red colored insects that live in cracks and crevices, behind old wall paper. They live off of blood. They do not like light; they seem to become very active around early morning, around 3am to 5am. They live off of blood and are attracted to heat. They are often found around the bed area because obviously you are their warm breakfast and are non-moving easy target. Once they get their meal they retract to their dark home. They can live for months without a meal. Their bites look like little red marks and for some people they itch. They can also feed off your pets if they need a meal and you are not available. Although they most commonly live around the bed area they can live in other areas of your home, furniture and clothes.
Where are They Found?
Bed bugs are very live with any socioeconomic class and take residence in any type of living conditions. They have been documented to be found in government buildings, hotels, schools, homes, movie theaters, college dorm rooms, apartment complexes, etc. They are found in new clothing that you just brought home from the store. They are found in very clean homes and hotels. Yes they are found in expensive and inexpensive hotels, cruise ships, and airplanes.
What Diseases to Bed Bugs Transmit?
Bedbugs, despite being annoying, creepy, and leaving you with tell-tale red bit marks, are not believed to spread diseases.
Bed bugs seem to carry with them an unwarranted social stigma. Some people may have allergic reactions, and some may suffer from insomnia and anxiety as a result of bed bugs. Bed bugs are an economic burden to our society as well. However, they have not been shown to transmit any diseases, as other blood sucking parasites are known to do.
How Can I Prevent Bed Bug infestation or Get Rid of Them If My Home has been Infested?
A little knowledge you can prevent a home infestation and allow you to continue to get a good night’s sleep.
Should your dwelling be infested a good pest control service can help you successfully rid your home of theses pests, but it does take about 4 or 5 treatments. There are some non-chemical ways to also fight and prevent bedbugs. High heat, freezing, and the use diatomaceous earth have also been shown effective in the fight against bedbugs. You may want to research these non-chemical ways that can prevent or work jointly with pest control. If you do decide to use diatomaceous earth as a means of pest control do not buy from the pool supply store. This type is used for pool filters. It is treated differently and is not meant for indoor home pest control purposes and can be harmful to you and your pets.
I travel what can I do to prevent bringing bedbugs home?
At the hotel inspect the room: check the mattress, headboard, luggage rack for dark blood spots and bedbugs. MSNBC and Bed Bug Central provide excellent resources on how to do this. Their links are at the end of this post. The following suggestions and video was listed on MSNBC Dateline

• Peel back the bed sheets and check the mattress, running your fingers along the upper and lower seams. Make sure to check the mattress tag, bed bugs often hide there.
• Experts recommend removing and examining the headboard if possible. Check for tiny black spots (excrement) that are smaller than poppy seeds. You may also see translucent light brown skins or, in the case of an infestation— live bugs.
• Check the bedside table. Look for signs of bed bugs in the drawers and along the wall on the side of the bed that is less likely to be disturbed by cleaning staff and guests.
• You may want to elevate suitcases and keep them off the floor, like on a luggage stand.
• If you see powder in the drawers or on the headboard, it is likely that the room has already been treated for bed bugs by an exterminator.
• If bed bugs are detected, travelers should request for another room. Be sure to inform hotel management.
• Just moving to a different room may not be the total answer. You should repeat the thorough inspection of any new or different room you are offered.
• When you pack to leave, inspect your luggage carefully first, and inspect every item as you pack to help detect any bugs or their signs. Laundering most cloth items with typical hot water and detergent followed by drying on low heat for at least 20 minutes (or standard dry cleaning) should kill all bed bugs in or on such items. Sealing freshly-laundered items inside a plastic bag should help keep any more bed bugs from getting in those items later to hide (and be carried back with you).

I hopes to increase your awareness and connect you to some resources that can educate you more on how to prevent spread of bedbugs, which are free loading hitchhikers. Contact your local health department or a reputable pest control service if you have specific questions. Remember, lice, mice and cockroaches pose much greater health risks, as far as disease transmission is concerned. I have compiled a list of website links that can be helpful to you. Bookmark them for future reference:,0,4951231.photogallery

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Limitations to the September 23, 2010 provisions of the Healthcare Reform – Affordability Care Act. Are you covered?

On September 23, 2010 certain provisions of the Healthcare Reform – The Affordability Care Act went into effect:
Adult children can stay on their parents healthcare plans until the age of 26 years old – does not apply to young adults that do have healthcare coverage through a job and at the parent’s choice.
Free preventive care – no more co pays and deductibles, co insurance payments for test such as a mammogram, colonoscopy, etc. This is for new plans started on or after September 23, 2010. It does not include plans already in effect before the law passed.
Insurance companies can no longer rescind coverage. This starts in January 2011 for most people at the beginning of their health plan year. It prevents insurance companies from searching for errors or mistakes in the application to drop or deny coverage when person gets sick.
Appealing insurance company decisions can happen in two ways: by appealing through the insurer or through an independent decision maker. Individuals are guaranteed the right to appeal insurance company decisions to an independent party. This is for new policies started on or after September 23, 2010. It does not affect those policies in effect before passing the law.
No more lifetime limits on healthcare coverage. Insurance companies cannot set lifetime limits on certain benefits, such as hospital stays. This is only for new plans established on or after September 23, 2010. It is does not affect those policies in effect before passing of the law.

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