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Managing Dementia’s Side Effects with Essential Oils

By Health, Long-Term Care

Now, more than ever, many are turning to a more holistic approach to medicine. For generations, essential oils have been used to ease symptoms of depression, anxiety, and insomnia.  Some research suggests that aromatherapy and the use of essential oils may be useful in the treatment of certain symptom’s of Alzheimer’s disease and other types of dementia.

Essential oils may be inhaled, applied to the skin, or ingested depending on the type of oil and its level of concentration. It is important to note that although essential oils have been used for generations and are thought to be safe, they are not regulated by the Food and Drug Administration, so you should always consult with your doctor before using to ensure that specific oils will not have any negative reaction with medications.

Some of the essential oils that been shown to be effective in alleviating different symptoms of dementia are:

  1. Lavender

Lavender is said to be calming and able to balance strong emotions. It is also an antidepressant and useful in cases of insomnia. Use it in the evening to promote better sleep, or any time of day to promote better mood.

  1. Peppermint

Peppermint is energizing and can be used to stimulate the mind. It is best used in the morning, and can be inhaled directly, diffused in the room, used as a massage oil, or even placed in a bath.

  1. Bergamot

Bergamot can be used to relieve anxiety, agitation, mild depression, and stress. It is a mood elevating and calming oil, that can also be used to relieve insomnia. It can be placed in a bath, used as a massage oil, diffused through a room, or sprayed on clothing or linens.

  1. Rosemary

Much like peppermint, Rosemary is an uplifting oil used to stimulate the mind and body. It may help improve cognitive performance and mood. Rosemary has also been known to ease constipation, symptoms of depression, and reinvigorate the appetite.

  1. Ginger

Ginger oil is helpful for anyone struggling with digestion issues. It is commonly used to treat a loss of appetite and constipation and can help promote good eating habits. Ginger oil can be applied directly to the skin as an abdominal massage, diffused, sprayed or placed on a compress.

  1. Lemon

Lemon oil is one of the most studied and effective oils. It has been shown to help calm and relax people who are dealing with anxiety and insomnia, improve memory and ease digestion. Lemon oil can be dropped in a bath, inhaled directly, diffused, sprayed or applied directly to the skin as a massage oil.

  1. Ylang Ylang

Ylang Ylang oil can help ease depression while also promoting good sleep. This is a great oil not only for the person living with dementia, but also for caregivers struggling with restlessness and lack of sleep. Ylang Ylang is often combined with lemon oil and can be placed in a bath, inhaled, diffused, or sprayed.

June 26, 2020
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How to Stay Connected to Loved Ones in Nursing Homes During a Pandemic

By Health, Long-Term Care

 

Family caregivers have now faced weeks or even months of physical separation from their loved ones in nursing homes and other long-term care facilities in order to protect them from Coronavirus. The restrictions on in-person visitation in long-term care facilities during the pandemic have made it challenging for family caregivers to stay close and present in the lives of their loved ones. The lack of family contact and attention can create feelings of isolation and anxiety for a resident, and additional stress for already worried families and friends, who are used to visiting in person.

While you may be unable to visit your loved one in-person, it is possible to brighten their day and try to ease feelings of isolation. Here are some ideas for staying emotionally connected to loved ones while visitor restrictions are in place:

  • Plan a virtual visit. There are several apps that will allow you to meet with your loved one virtually, including FaceTime, Zoom, and Skype. Most facilities are more than willing to assist your loved one in dialing in to a call. Some facilities even have iPads for easier viewing.
  • Send snail mail. Cards and letters are an easy way to tell someone you are thinking of them. Write an update about routine family activities. Have your children draw a picture. Include a photo showing your quarantine activities. Receiving updates will be reassuring to your loved one that you are okay during this health crisis and will provide your loved one with a genuine connection to you.
  • Create a photo book. Create a photo book with photos of what you, family, and friends have been up to. Include captions identifying family members and friends, with a small description. It can be as simple as a few pages printed from your home printer and stapled together, a poster board assortment, or a professionally bound book from Shutterfly or another online printing company. Most facilities will accept envelopes or packages at the front desk and will have staff members deliver to your loved one’s room, or they can always be sent in the mail.
  • Have a window visit. Many facilities will schedule a specific time for your family to “meet” your loved one through a window on the ground floor. You will be on the outside, and your loved one will be safely on the inside. You can chat, share smiles and laughs, and a touch through the glass. You can make special occasions, like a birthday or holiday, extra special with handmade signs.
  • Create a phone chain. Create a schedule of different family members and friends to each call your loved one on a specific day. This is a great way to connect others also feeling isolated, especially seniors and those living alone, with your loved one. Plus, a regular daily phone call gives your loved one something to look forward to.
June 4, 2020
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COVID-19: Tips for Supporting Loved Ones with Dementia Living in Nursing Homes During the Pandemic

By Elder Law, Health, Long-Term Care

There is no evidence to suggest that dementia itself increases the risk for Coronavirus, just like dementia does not increase risk for flu. However, behaviors, increased age, and common health conditions that often accompany dementia may increase risk. For example, people with dementia may forget to wash their hands or take other recommended precautions to prevent the illness. Viruses like COVID-19 or the flu may worsen cognitive impairment due to dementia.

 

The CDC has provided guidance on the prevention and control of COVID-19 in nursing homes. Precautions may vary based on local situations. If you have a loved one with dementia living in a nursing home:

 

  • Check with the facility regarding their procedures for managing COVID-19 risk. Make sure the facility has your emergency contact information and contact information for another family member or friend as backup.
  • Do not visit your loved one in the facility if you have been exposed to COVID-19, or have any signs or symptoms of illness.
  • Depending on the situation in your local area, facilities may limit or not allow visitors, in order to protect the residents.
  • If visitation is not allowed, ask the facility how you can have contact with your loved one. Options may include telephone calls, video chats, or emails to check in.
  • If your loved one is unable to engage in calls or video chats, ask the facility how you can keep in touch with staff in order to get updates.
June 3, 2020
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The Four Criteria to Qualify for ICP Medicaid in Florida

By Asset Protection Planning, Elder Law, Long-Term Care, Medicaid Planning

The Four Criteria to Qualify for ICP Medicaid in Florida

The Institutional Care Program (ICP) is a Medicaid program that helps Florida’s senior and disabled residents in nursing facilities pay for their long-term care. Eligibility for ICP Medicaid is determined on a case-by-case basis, and there are may rules and regulations that must be followed in order to qualify. There are four main criteria to qualify for ICP Medicaid in Florida:

Income

In order to qualify for ICP Medicaid, applicant’s total gross monthly income cannot exceed three times the SSI Federal Benefit Rate. This number changes yearly, and as of January 1, 2020, the income limit is $2,349.00. For eligibility purposes, any income that the Medicaid applicant receives from any source is counted. Examples include wages from employment, Social Security income, pension payments, annuity payments, alimony payments, IRA withdrawals, and stock dividends.

If the ICP Medicaid applicant has a healthy spouse, the spouse’s income is not counted. If the healthy spouse’s income is less than $2.114.00 per month (the Minimum Monthly Maintenance Needs Allowance or MMMNA), a portion of the applicant’s income may be diverted to the healthy spouse to ensure the he or she as sufficient funds to live.

Individuals with income over the ICP Medicaid income limit may still qualify for Medicaid if they set up a Qualified Income Trust (QIT). Once the QIT is established, the excess income over the income limit is deposited into the trust each month, so that the applicant’s income outside of the trust each month is below the income limit. The QIT must meet specific requirements and be approved by the Department of Children and Families Regional Legal Counsel.

Assets

For the purposes of Medicaid eligibility, an applicant’s assets are classified into two categories: countable and non-countable. Countable assets are considered for Medicaid eligibility purposes, and non-countable assets are not.

Countable assets include cash, stocks, bonds, investments, savings accounts, checking accounts, Certificates of Deposit (CDs), and real property.

Some examples of non-countable or exempt assets are the applicant’s homestead property, certain motor vehicles, irrevocable pre-paid burial plans, burial funds up to $2,500.00 which are kept in a separate account, some life insurance policies, annuities in the payout period,  and retirement plans that are being drawn from on a monthly basis.

In order to qualify for ICP Medicaid, an applicant’s countable assets cannot exceed $2,000.00. If the ICP Medicaid applicant has a healthy spouse, the spouse can retain up to a maximum of $128,640.00 of the couple’s jointly held assets.

Level of Care

To qualify for ICP Medicaid, an applicant must require a Skilled or Intermediate level of care in a nursing home, as determined by the Comprehensive Assessment and Review for Long-Term Care Services program (CARES). Applicants must be appropriately placed in a Medicaid facility able to provide the level of care needed. Once an application is submitted, the CARES team will determine the applicant’s appropriate level of care. To determine the level of care, the CARES team will conduct a face-to-face interview with the applicant to collect information on the applicant’s medical history and evaluate how the applicant performs activities of daily living. Activities of Daily Living (ADLs) include:

  • Bathing
  • Dressing
  • Eating
  • Maintaining continence
  • Toileting
  • Transferring

Based on the CARES team’s assessment and the applicants signed physician form certifying that the applicant requires a nursing home level of care (the “3008” form), the CARES team issues a level of care determination.

Transfers

Transfers of any assets or income made by an applicant or an applicant’s healthy spouse may affect the applicant’s ICP Medicaid eligibility.   Florida has a Medicaid Look-Back Period, which is a period of 60 months that dates back from the applicant’s Medicaid application date. Upon application, the Department of Children and Families will check to ensure no income or assets were sold or given away for less than fair market value. If a transfer was made to become Medicaid eligible within the look-back period, a period of Medicaid ineligibility may exist. The period of ineligibility will vary depending on the value of the transferred income or asset.

Certain transfers, such as a transfer to a spouse or disabled adult child, are allowable, and do not affect Medicaid eligibility. Other allowable transfers may include the transfer of the homestead property to the following relatives:

  • the applicant’s spouse, minor child, or blind or disabled adult child,
  • the applicant’s sibling who is a joint owner of the home, and who resided there at least one year prior to the applicant’s institutionalization; or
  • the applicant’s child who reside in the home and provided care for at least two years immediately before the applicant’s institutionalization.

It is important to note that not meeting all the criteria above does not mean that you or your loved one is not eligible or cannot become eligible. There are various strategies that can be employed to help you become eligible.  The attorneys at Bach, Jacobs & Byrne, P.A. can conduct an in-depth review of your financial and medical situation to develop a plan that is best suited for you and your loved ones needs.

May 8, 2020
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When can a nursing home discharge a resident?

By Asset Protection Planning, Elder Law, Long-Term Care, Medicaid Planning

According to Florida Statute §400.0255, a nursing home must provide notice to a resident it is discharging at least 30 days in advance of the date of discharge. There are multiple reasons which a nursing home can cite for discharging a patient – the following are recognized as valid reasons for patient discharge, except in the case wherein the discharge would be medically harmful to the patient:

-A discharge from the nursing home is medically necessary or would be medically beneficial to the patient, if the facility cannot meet the medical needs of the patient

-The patient poses a threat to the health and safety of other patients or of the facility’s employees

-The facility itself is unsafe for the patient

-The resident no longer requires nursing home care due to an improvement in condition

If a patient feels that he/she has been unjustly discharged, that resident has the right to a fair hearing to challenge the proposed discharge. If the patient files a request for a hearing within 10 days of receiving notice of discharge, the discharge is stayed until the hearing decision is reached. The patient has up to 90 days to file a request for a hearing, but he/she may be discharged after 30 days of initially receiving notice of discharge if the request for a hearing was not filed within the 10 days after the receipt of that notice.

It is important to note that the notice of discharge provided by the facility must specify the reason for discharge under state or federal law, as well as the procedures for appeal; if this information is not provided, the discharge is not valid.

June 7, 2019
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Can nursing homes keep you from seeing your loved one?

By Elder Law, Long-Term Care, Medicare

No, it is against the law for nursing homes to ban visitors from seeing their loved ones, unless the visitor is deemed dangerous to the other residents of the nursing home. According to the Centers for Medicare and Medicaid Services, nursing home residents have the following rights when it comes to visitors:

  • To spend private time with visitors
  • To have visitors at any time, as long as you wish to see them, as long as the visit does not interfere with the provision of care and privacy rights of other residents
  • To see any person who gives you help with your health, social, legal, or other services at any time. This includes your doctor, a representative from the health department, and your Long-Term Care Ombudsman, among others.

If you feel that a loved one is being deprived of his/her rights as a nursing home resident, you have the right to register a complaint with the nursing home as a resident advocate. If the facility’s management does not resolve the issue, one can also report the problem to the Florida Agency for Health Care Administration at 1-888-419-3456 or to the Long Term Care Ombudsman of Florida at 1-888-831-0404.

January 28, 2019
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The Prevalence of Resident-on-Resident Elder Abuse in Nursing Facilities

By Long-Term Care

A study published in the journal Annals of Internal Medicine states that at least one in five nursing facility residents is subject to abuse by other nursing facility residents. A large amount of this aggression in nursing facilities is due to the fact that some residents suffering from Alzheimer’s or Dementia are being placed in communal living environments that are unfamiliar to them, as they likely spent most of their lives in a private residence. This factor can exacerbate the behavioral issues in some individuals with these afflictions and increase the likelihood of conflict in nursing facilities. Resident-on-resident abuse can take on many forms, including: physical, verbal or sexual abuse.

Many individuals that reside in nursing facilities have lowered inhibitions due to mental or physical impairment, which can contribute to the rate of resident-on-resident abuse as well. To combat this issue, there are steps nursing facilities can take to reduce agitation in patients suffering from dementia or other neurodegenerative disorders. These include, but are not limited to: reducing or eliminating loud noises, introducing music therapy, introducing aromatherapy, reducing overcrowding, aiding residents in getting more exercise and eliminating the use of overly bright lighting. Additionally, caregivers in nursing facilities can be taught more effective techniques for handling situations in which a resident with Alzheimer’s or Dementia becomes agitated.

March 9, 2018
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Nursing Facilities: What is Myth and What is Fact?

By Long-Term Care

Many people are not as informed regarding the different aspects of nursing facility care as they would like to be, and many have been misinformed as to what a nursing facility care encompasses and entails. A nursing facility, sometimes referred to as a nursing home or skilled nursing facility, is a communal residence that provides a high level of long-term personal or nursing care for elderly individuals who are unable to care for themselves properly. To help clear up some of the confusion regarding the purpose of nursing facilities, this post will list several myths regarding nursing facilities and provide facts that disprove these myths.

Myth #1: All The People Who Live In Nursing Facilities Are Dying

Nursing facilities provide medical services to individuals that have conditions that require continuous care. Many nursing facility residents are not dying, but rather need higher levels of care than can be provided by an assisted living facility.

Myth #2: Nursing Facility Is Another Term For Hospital

Nursing facilities are not hospitals, although they provide many types of medical and nursing care. In a nursing facility, residents are cared for while also maintaining as active a lifestyle as possible. Nursing facilities do not have restrictive visiting hours and the environment in a nursing facility is much less clinical than it is in a hospital. Additionally, nursing facilities offer activities to keep residents engaged in the community and that allow for socialization.

Myth #3: Residents of Nursing Facilities Lose All Their Independence

Nursing facilities respect and encourage independence as much as possible. Becoming afflicted with a condition that requires admittance into a nursing facility does not mean an individual is losing their independence, but simply that they need extra assistance with day-to-day tasks. Additionally, as long as they are not incapacitated, nursing facility residents retain all their legal rights and can make choices about their activities, schedule and health care, among other things.

Myth #4: There Is No Privacy In A Nursing Facility

In a nursing facility, residents’ rooms are considered private and staff will knock before entering. A resident’s room is their own domain and they are given as much personal space as is allowed for their medical care to still be provided in an effective manner. However, if residents want to engage socially, there are community areas in which they have the ability to do so.

February 23, 2018
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Hasbro’s “Joy For All” Companion Pets: Could They Be A Vital Tool for Boosting Morale In Nursing Homes?

By Long-Term Care

Hasbro has created a new brand of product entitled Companion Pets that are designed for purchase and utilization by elderly individuals. On the Companion Pets website you are presented with two options; you can either purchase a Companion Cat or a Companion Dog (The Companion Cat comes in multiple colors). These “pets” are actually robotic animals complete with fur as well as the abilities to move, fall asleep, roll over and make noises. They have been used in therapy settings to comfort dementia patients and given as presents to aging friends or parents that are in need of companionship but cannot take care of an actual animal. Additionally, these Companion Pets are commonly used by nursing homes to bring joy to their residents and calm them down should they become agitated. In some cases, Companion Pets have calmed nursing home residents down from a panic and prevented staff from being forced to utilize a tranquilizing agent on them. These robotic animals are battery operated, but can complete realistic movements that an actual cat or dog would and even make animal sounds. These pets will even fall asleep after a few minutes of an individual not petting them or giving them attention, only to wake back up as soon as they are touched or held. If a nursing home or assisted living facility does not allow pets or, at the very least, has strict rules regarding them, this may be an option for an elderly individual who lives alone in a place such as this and lacks companionship.

January 23, 2018
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Social Media Abuse in Nursing Homes

By Long-Term Care

As technological advances increase, so do the ways in which immoral individuals use technology to exploit others. There have been numerous instances in which nursing home employees have been fired or otherwise disciplined for sharing inappropriate content, via social media outlets, that features nursing home patients. This is a newer type of elder abuse that is becoming more prevalent and that everyone needs to be aware of. Posting embarrassing photo or video content of senior citizens is malicious, dehumanizing and violates elderly individuals rights to privacy. This applies especially to nursing home patients, as they are often mentally or physically impaired and unable to stand up for themselves. Everyone should be aware of the existence and growing presence of social media abuse when it comes to the elderly, so that they know to report elder abuse if they encounter it in any form.

To report elder abuse or exploitation, call the Florida Abuse Hotline at: 1-800-962-2873.

December 29, 2017
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