People with Parkinson’s can have trouble speaking clearly. But simple drills can train them to talk louder to regain vocal Regina Nuzzo December 25, 2006(The Times) – Martin Romoff used to rely on his voice to make a living as a Los Angeles tire salesman. But two decades of Parkinson’s disease muffled his speech and spoiled the art of easy conversation. Even his wife, Shirley, asked him to repeat himself over and over.

Then he learned about a special kind of voice training. For four one-hour sessions over a month, Romoff worked with a speech therapist in a program designed specifically to help people with Parkinson’s disease retain — or reclaim — the clarity of their speech.

Developers of the therapy, called the Lee Silverman Voice Treatment (also known as LSVT or LOUD), say that by making a healthy, intensive effort to speak more loudly, people with Parkinson’s disease can regain control of their speaking voices. Although the program is now administered in 30 countries, the neuromuscular mechanisms behind its effects are still unclear. Nor have there been state-of-the-art, double-blind controlled studies to test how well it works.

Now researchers are studying LSVT in a small clinical trial that could help pinpoint how the program’s simple drill profoundly affects the speech system.

Parkinson’s disease afflicts 500,000 to 1 million Americans, most of whom are diagnosed after age 65. The disorder involves the death of brain cells that produce the nerve chemical dopamine, which helps carry commands from the brain’s muscle-control centers.

People with Parkinson’s disease move slowly, and their arms and legs may be rigid and shaken by tremors. Less well known is that Parkinson’s can also take away patients’ normal voice because it strikes vocal cord muscles as well. Speech becomes slurred, and voices soft, hoarse or shaky.

The problem can be tremendously isolating. “One of my patients in New York would say to me, ’If I have no voice, I have no life,’ ” says Lorraine Ramig, speech science professor at the University of Colorado at Boulder and one of LSVT’s developers.

Although up to nine out of 10 of people with Parkinson’s disease have speech and voice disorders (known collectively as dysarthria), only about 4% receive any type of speech therapy. Researchers have tried nonbehavioral approaches, such as implanting collagen into vocal cords and stimulating the brain with electrodes, but nothing has proved to have lasting success. In fact, some older types of brain stimulation have been shown to make dysarthria worse, not better, says Bruce Gerratt, professor of head and neck surgery at UCLA medical school.

The LSVT program, developed at the Lee Silverman Center for Parkinson’s Disease in Arizona, uses exercises that focus on a single, simple goal: producing a healthy, louder voice through extra effort.

“We tell people, ’Speak louder than you think you need to,’ ” says Cynthia Fox, a researcher at the National Center for Voice and Speech in Denver and vice president of the LSVT Foundation.

The focus on volume is “deceptively simple, but you get a lot of bang for your buck,” says Geralyn Schulz, a speech science professor at George Washington University. “Even without a speech therapist telling you to open your mouth wider, or take a deeper breath, or move your tongue more, you automatically do those things when you speak loud.”

That is the opposite of what normally happens with Parkinson’s patients, who generally make short and small movements: Handwriting gets tiny, walking strides get shorter, and speech suffers from a lack of bigness .

Also crucial, Ramig believes, is concentrating on a single aspect of speech. This keep-it-simple approach is especially relevant for Parkinson’s patients, who often have memory and learning problems.

To explore whether volume is the key, or if other simple goals can also work, Ramig and colleagues are conducting a clinical trial in Denver. Healthy volunteers and Parkinson’s patients will undergo either LSVT training or a program that targets articulation instead. Researchers hope to enroll a total of 80 patients; results are expected next year.

Scientists also need to get a better sense of how well LSVT works. Although small studies have shown promising results, larger-scale multicenter clinical trials of the therapy are lacking, Ramig says. It’s also not clear what affects an individual’s success with the program, including factors such as the patient’s age, time since diagnosis, cognitive abilities and stage of disease.

Nor do therapists know how long the effects will last.

After Martin Romoff completed the LSVT program about three years ago, he and his wife noticed that his voice was stronger. “Speaking was easier, and people understood me better,” Romoff says.

The positive effects lasted for a while, he says, but his voice has since slipped back into old patterns.

To help Romoff and others like him, Ramig and her colleagues are experimenting with Web cams, software programs and other technology to help patients continue their practice.

Parkinson’s: A focus on big movements

Parkinson’s patients can learn to “speak loud,” but can they also learn to “move big”?

Researchers are experimenting with training patients to take big steps, make large gestures and generally exert a grand effort in all movements. The goal is to combat the characteristic slowness of Parkinson’s disease — known as bradykinesia — by encouraging them to crank up the drive to their muscles, says Becky Farley, a physiology professor at the University of Arizona and a developer of the program. As with the Lee Silverman Voice Treatment for voice control, patients focus on a single goal: bigness.

In a study of 29 Parkinson’s patients and healthy volunteers, the new therapy program improved some facets of patients’ movements. Their strides were longer and their torso rotated more freely, both immediately after therapy and three months later. And they could remember to take bigger steps even when their attention was diverted elsewhere, such as having to recite the days of the week backward.

Early-stage patients saw better results than those with more advanced Parkinson’s, especially in walking speed.

RIGHT ACCORD specializes in Parkinson Care. Our caregivers are trained and certified and has special training in Parkinson Care. For FREE Care Consultation and Assessment, please call 1.941.366.0801 or Toll Free 1.877.685.3889.

RIGHT ACCORD Private Duty-Home Health Care is a supporter of the Parkinson Neuro Challenge Foundation in Sarasota, Florida. On March 3, 2011, Neuro-Challenge brings 2nd Annual Cause 4 Fashion, a Fashionable Fundraiser for Parkinson Disease.

About Neuro Challenge Foundation: The Neuro Challenge Foundation (NCF) is dedicated to enhancing the quality of life of people with Parkinson Disease and their caregivers through service, education, and research.  For more information, please call 1.888.623.4483 or visit www.neurochallenge.org

New Certification Raises Standard for In-Home Caregivers

The senior care industry has grown dramatically in recent years along with the number of seniors needing care. Some seniors move into assisted living facilities or skilled nursing facilities as chronic conditions begin to affect their daily lives. Many more, however, are choosing to remain in their own homes with the help of companion caregivers. “Home is where the heart is” as the saying goes. But it can be difficult to find reliable help and the skills and quality of caregivers can vary greatly. Add to that limited supervision of those caregivers, if any, and home care comes with a set of uncertainties all its own. But one senior care network is changing all that with a landmark program aimed at setting a new standard for senior home care.

Hired caregivers, also called personal or companion aides, frequently perform daily services for seniors including light housekeeping, laundry, meal prep, shopping and errand services. In Florida, there are home health aides who may also provide personal care assistance for their clients such as bathing, dressing, grooming, and transfer and ambulation assistance. They often serve clients recovering from injury, surgery, and those suffering from arthritis, heart disease, and other chronic conditions. A growing number of caregivers are the sole custodians of seniors suffering from Alzheimers disease and other dementias. Under these circumstances, a caregiver’s responsibility can be very great. One might expect the average caregiver to be a highly trained professional. In contrast, however, the occupational characteristics of the typical caregiver, as reported by the Bureau of Labor Statistics, are characterized by low skill requirements and high emotional demands. Frequently, caregivers rely only on care experience they gained while caring for an ailing family member. They then hire themselves out, either independently or via an agency, to perform similar care for others. Unfortunately, each caregiver’s personal experience and skill level can vary greatly.

According to Rosemarie Tamunday-Casanova, RN, owner of RIGHT ACCORD Private Duty-Home Health Care  in Sarasota, Florida  “Training, or lack of it, is the issue. We’ve always insisted on a standardized training program for our caregivers. But we’re an exception. Many companion care companies, some of them franchises, offer very limited caregiver training. And some provide no skills training at all to their employees. Independent caregivers, those who are not affiliated with any agency, certainly don’t seek training. That’s a scary situation when you are hiring someone to care for yourself or a loved one.”

Most care agencies depend on the personal experience that each new caregiver brings with them. Without a training program, there’s no predictable skill standard. Until recently, the only consistent measure of skill was among state certified nursing assistants and home health aides, most of whom work for hospitals, facilities and home-health companies. It’s clear, however, that a majority of seniors prefer to remain in their own homes and will continue to rely on home care providers or companion caregivers for ongoing assistance.

To rectify the varying skill set of caregivers, The Senior’s Choice, Inc, the leading membership network of independent companion care companies, has established a new certification for companion caregivers, the Certified Companion Aide, (CCA^® ). Steve Everhart, president and founder of The Senior’s Choice stated, “Our mission is simple, we want to ensure the best home care possible for seniors – they’ve earned it, they deserve it. The CCA^® will stand head and shoulders above standard caregivers in both education and skill. And the type of person drawn to the CCA is big-hearted and committed to exemplary senior service.”

In the groundbreaking program, caregivers study 19 core subjects relating to senior care and then pass a battery of tests to ensure competency in the material. Topics include Communication, Understanding Aging, Emergency Preparation, Personal Care, Disability Issues, Mental Health & Illness, Nutritional Needs of Clients, and much more. The process prepares caregivers to consistently and professionally perform exceptional in-home care for seniors who choose to remain independent at home as long as possible.

Network members are very excited to be part of this certification opportunity. Everhart commented, “Our caregivers are great people who give tirelessly of themselves to help seniors. Now, they’ll have something that not only shows their level of dedication but actually improves the service they’re providing. The caregivers benefit by the additional education and seniors will certainly benefit through the CCAs’^® service. At the heart of it, that’s what counts.” The program is being rolled out exclusively among over 250 Senior’s Choice network member agencies throughout the US and Canada and raises the bar for companion care nationwide.

For further information contact:

Rosemarie Tamunday-Casanova, RN

RIGHT ACCORD Private Duty-Home Health Care

Phone: 1.877.685.3889 or 941.366.0801

Email: rose@rightaccordhealth.com

www.RightAccordHealth.com

Our senior clients and their caregivers enjoy Arts and Theater in Sarasota, Florida. This month at the Van Wezel has exciting shows. For more information, visit www.VanWezel.org

So the “Aha” moment arrives. Circumstances make you realize two things. 1) I’m not as young as I used to be, and 2.) “Old age ain’t for sissies” as the great Bette Davis once said.

Gradually, or sometimes suddenly, it happens… we can’t keep up with household chores, we can’t see the street signs to drive safely, we give up cooking or we can’t walk without holding on to the furniture. And it begins, a nagging fear that we’re losing our independence. In fact, loss of independence is the biggest fear among seniors. So what is the typical senior response? Pull ourselves up by the bootstraps and keep on going, of course! Call in the kids to help out! They’re supposed to take care of us in our old age, aren’t they? Unfortunately, the kids have spouses and children of their own. And they have full time jobs, not to mention they live out of town. It’s time for a new strategy.

Many seniors are finding the solution to remaining independent at home lies outside the family circle with paid caregivers. Rosemarie Tamunday-Casanova, RN  of RIGHT ACCORD Private Duty-Home Health Care explains, “Most seniors find caregivers in two ways.

The old way is to run a classified ad or hire through a temporary service. The senior bears all the “employer” responsibility for this kind of caregiver.”

Tamunday-Casanova  recommends seniors ask the following questions of independent caregivers:

1. What client references can you provide?
2. What is your experience/background?
3. Do you have any certificates or training? Is it current?
4. Have you worked with ( Alzheimer’s disease, Parkinson, Cancer, etc)?
5. What would you do if I had medical emergency?
6. How much notice would I have if you could not come in for a day? Can you arrange your own substitutes?
7. How do I contact you?
8. Are you bonded? Have you ever been convicted of a crime?
9. Do you have liability insurance?

“These folks are usually less expensive but there’s a lot of risk involved in hiring them”, Tamunday-Casnova says. He continues, “The downside is:

• It‘s difficult to find the right person.  You are responsible for performing a criminal background check.
• You are responsible for finding a replacement if the caregiver is absent

• You bear the burden for withholding payroll taxes, and providing state mandated worker’s compensation coverage.

• You bear the burden for liability problems like theft from or damage to your property. “

The new way is to contract with a State licensed  Home Health Care – Companion Care Agency. These private agencies provide “in-home, non-medical care”. The number of agencies are growing quickly to meet the demands of a fast-growing senior population. They provide a wide range of services including light housekeeping, meal preparation, laundry, transportation, shopping & errands, and in many states including Florida,  including assistance with personal care. These one on one services can continue should the senior move into assisted living or even a nursing facility or hospital.”

Home Health Care and  Companion Care is usually available anywhere from a few hours up to 24 hours a day. Payment is private pay and may be covered by long term care insurance policies or Veterans Aid and Attendant benefits.

Some questions Tamunday-Casanova suggests you ask a Home Care – Companion Care agency:

1. Do they have references from other clients?
2. What services will they be providing?
3. What training/experience do the caregivers have?
4. How do they supervise their caregivers?
5. Are the caregivers bonded and covered by workers compensation insurance?
6. What is the schedule for service?
7. How do I change the schedule?
8. What if I have a problem with a caregiver?
9. Does the agency have an emergency or after-hours phone number?
10. What are the financial arrangements?
11. Who owns the agency? Is it part of a larger organization?
12. Are the caregivers employees held accountable by the agency or independent contractors accountable to no one?
13. Does the agency carry Professional Liability Insurance?

The Pros:

• Service is easily customized for each client’s needs

• Extensive hours available

• Staff is screened and supervised

• Agency is responsible for all employer tasks like payroll, taxes, liability insurance, workers compensation, bonding

• Agency is responsible for providing a replacement should the assigned caregiver fail to arrive or need a day off.

Tamunday-Casanova says, “This service is more expensive than independent caregivers but the right agency will provide the most customizable, reliable, worry free, in- home service available.”

For FREE in-home care consultation or assessment, call 941.366.0801 or Toll Free 1.877.685.3889

Private Duty-Home Care services provided in Sarasota, Venice, Longboat Key, Casey Key, Nokomis, Siesta Key, Lakewood Ranch and surrounding areas.

Our seniors and their caregivers enjoy different activities in the area. Sarasota SpringFest is scheduled on March 19, 2011. A FREE day of Family Fun and local business expo from 9am-4pm. Fun, Food, Music, PAL’s Sailor Circus and Egg Hunts! For more information, visit www.SarasotaSpringfest.com or call 941.922.3866

Home Care Executive Earns Approval for Alzheimer’s Disease Training Provider

Sarasota, Florida, January 17, 2011.  Rosemarie Tamunday-Casanova, RN – RIGHT ACCORD Private Duty-Home Health Care, Administrator and Owner becomes a certified Home Health Alzheimer’s Disease and Related Disorders (ADRD) training provider through the Florida Policy Exchange Center on Aging (FPECA), A Multi-University Consortium at the University of South Florida.

According to facts and figures reported by the Alzheimer’s Association, an estimated 5.3 million Americans of all ages have Alzheimer’s disease. This figure includes 5.1 million people aged 65 and older and 200,000 individuals under age 65 who have younger-onset Alzheimer’s. The Alzheimer’s Association estimates that there are 500,000 Americans younger than 65 with Alzheimer’s and other dementias. Of these, approximately 40 percent are estimated to have Alzheimer’s. One in eight people aged 65 and older (13 percent) have Alzheimer’s disease. Every 70 seconds, someone in America develops Alzheimer’s. By mid-century, someone will develop the disease every 33 seconds.  www.http://www.alz.org/alzheimers_disease_facts_and_figures.asp

The Home Health Care Alzheimer’s Disease Certification is a two-hour State mandatory training required for employees hired to work with elderly in a home care setting. The curricula must be taught exactly as approved. No modifications are permitted. The Department of Elder Affairs (DOEA) reserves the right to attend and monitor training courses, review records and course materials approved pursuant to State Rules and Florida Administrative Codes.

Upon successful completion of the ADRD training, the trainee shall be issued a certificate of completion by the approved training provider. The certificate shall include title of the approved training course and the DOEA curriculum approval number, the expiration date of curriculum, the number of hours of training, dates of attendance, location, trainee’s name, the providers name and DOEA approval number.

A list of all approved Home Health Alzheimer’s Disease and related Disorders curricula is posted on www.trainingonaging.usf.edu.

RIGHT ACCORD Private Duty-Home Health Care specializes on clients with Dementia or Alzheimer’s Disease. Caregivers are trained, certified and undergo monthly in-service training to review on different home care procedures. Clients and families are assured that  home care providers assigned to their loved ones are experienced,  well aware of the disease process and care at different stages.

In-Home Care Services provided in Sarasota, Venice, Longboat Key, Siesta Key, Osprey, Nokomis, Casey Key and neighboring cities.

For free professional in-home care consultation and assessment, call 941.366.0801.

Alzheimer’s Support Groups are available in Sarasota, FL.

Alzheimer’s Association-Florida Gulf Coast Chapter affiliated support groups are for family members, caregivers, and others interested in learning more about Alzheimer’s disease.  Meetings are open to everyone and free of charge.  Support group facilitators have received training as required by Chapter and National Alzheimer’s Association standards.  For program information and to verify meeting dates, times, and locations, please use the telephone contacts listed below.  For other questions or to arrange free respite care so you can attend a group, call the  Sarasota office at (941) 365-8883 or 1-800-772-8672.

For further information contact:

Rosemarie Tamunday-Casanova, Administrator

(941) 366-0801

Email: rose@rightaccordhealth.com

www.RightAccordHealth.com

November 23, 2010

FOR IMMEDIATE RELEASE

Good Deed to Benefit Local Alzheimer’s Organization

Sarasota, November 23, 2010 RIGHT ACCORD Private Duty-Home Health Care

Joined the Gulf Coast Alzheimer’s Association Annual Memory Walk  held on October 23, 2010. RIGHT ACCORD and its team of walkers donated over $1,000 and the association raised over $148,000 this year.

Memory Walk is the nation’s largest event to raise awareness and funds for Alzheimer care, support and research — and it calls on people of all ages to take action in the fight. Year-round, the participants are leaders in the effort to defeat this devastating disease.

Participating in Memory Walk was fun with a group. We asked co-workers, family and friends to walk with us as a team. “I was amazed at how many people wanted to help.” Said Tamunday-Casanova.

Every Memory Walk participant was asked to raise money for the fight against Alzheimer’s. The Alzheimer’s Association staff was there and ready to support us every step of the way with tips, tools and advice.

“Memory Walk was truly a unique experience. We saw the difference we can make as we walked to change the course of Alzheimer’s together. “said Rosemarie Tamunday-Casanova

For more information on Gulf Coast Alzheimer’s Association www.alz.org/flgulfcoast

The Company can be reached at (941)366-0801.

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone’s favorite foods are always on the agenda. On the top of the menu is Grandmas Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side, perhaps a half cup full of salty.

Though the family was disappointed over the cake, of more concern was Grandma’s confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma’s mental state?

One might say that for an elder person a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia?

An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia.

“Dementia causes many problems for the person who has it and for the person’s family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

• Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you’ve already given them the answer. They won’t even remember that they already asked the question.
• Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
  Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
• Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
  Poor judgment. Even a person who doesn’t have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
• Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
• Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can’t find these things later.
• Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
  Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
• Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people.”

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer’s disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer’s. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.

“The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it’s a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive.

The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support.” The Four Steps of Long Term Care Planning

Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients. Don’t forget care facilities as well. It may be the best loving care a family member can give is to place their loved one in a facility where that person is safely monitored and cared for.

RIGHT ACCORD Private Duty-Home Health Care is based in Sarasota, Florida offering in-home care assistance to clients and family by sending certified caregivers to assist seniors in the home from bathing, dressing, cooking, medication reminders, errands and transportation from few hours to 24 hours.  All caregivers are certified,  criminal background checked, employed by the agency.insured and bonded. Services are available in Sarasota and Manatee Counties, Venice, Nokomis, Osprey, Lakewood Ranch, Longboat key and its neighboring towns.

Staff and caregivers of RIGHT ACCORD has specialized training and newly hired staff completed mandatory Alzheimer’s Disease and Related Disorders Training last July 23, 2010 conducted by Pam Polowski, Director Alzheimer’s Association Gulf Coast Florida Chapter.  Next training is scheduled for October, 2010.

Memory Screening is also available through the Sarasota Memorial Memory Disorder Clinic. Call 941.917.7197 or visit their website at: http://www.sarasotageriatrics.com

RIGHT ACCORD Private Duty-Home Health Care offered a training  class on  Elder Abuse, Neglect and Exploitation to all the staff and caregivers on August 26, 2010. The program was presented by Diana Hayden, Director of Community Education  from the Department of Children’s and Family/Adult Protective Services.

Many elderly people rely entirely on family or other trusted individuals to help them. Whether it is for physical needs or emotional needs, as people grow older they tend to need more and more help from others. This dependence on caregivers or family members makes an older person more vulnerable for abuse.

For example, an older person relying on her children to provide meals and transportation and help her with financial decisions finds it difficult to complain when one of her children takes advantage of her. If, for instance, the child takes her money, hits her or neglects her care, the parent may be threatened with loss of support from the child if the parent complains. The child may also use threats of violence to keep the parent in line.

It is estimated that 5% to 10% of elderly Americans are suffering abuse. According to the National Committee for the Prevention of Elder Abuse,

“Spiraling rates of elder mistreatment are reported by both practitioners and researchers. In a recent national study of Adult Protective Services (APS), typically the agency of first report concerning elder abuse, there were 253,421 reports of abuse of adults age 60+ or 832.6 reports for every 100,000 people over the age of 60 (Teaster, Dugar, Otto, Mendiondo, Abner, & Cecil, 2006). The National Elder Abuse Incidence Study (National Center on Elder Abuse, 1998) found that more than 500,000 persons aged 60+ were victims of domestic abuse and that an estimated 84% of incidents are not reported to authorities, denying victims the protection and support they need.”

Much attention has been focused on abuse in nursing homes but most of the elder abuse in this country is at the hands of family members or other caregivers in the home.

In 2004, Utah Adult Protective Services workers investigated approximately 2,400 allegations of abuse, neglect or exploitation of vulnerable adults. In Utah, a vulnerable adult is defined as an elder adult (65 years of age or older) or an adult (18 years of age or older) who has a mental or physical impairment, which substantially affects that person’s ability to protect or provide for themselves. The majority of the victims were females between the ages of 60-89 and 60% of the perpetrators were family members/relatives, while 24% were non-related paid caregivers.

The protective needs identified were as follows:

• self-neglect 31%
• physical abuse 16%
• exploitation 19%
• caretaker neglect 12%
• emotional abuse 19%
• sexual abuse 3%

In conducting the investigations, it was not uncommon to find that adults who were self-neglecting were also being exploited or abused. As stated previously, these statistics are based on approximately 2,400 cases, thus, if only one in ten cases are ever reported, it is possible that there were actually 24,000 or more cases in Utah that year. We suspect 9 out of 10 is close to the actual ratio of unreported versus reported cases in Utah.

We also believe that Utah’s lack of reporting elder abuse is not unlike other states in the country. We suspect all the states are experiencing close to the same ratios of underreporting as in Utah.

There are a number of reasons why incidents of abuse, neglect, or exploitation are not reported to Adult Protective Services or other authorities. One of the most common reasons is the victim’s fear of losing support. Many of the perpetrators are family members and the victim fears that reporting the crime will result in removal of the caregiver, as the perpetrator may face incarceration or may discontinue relations with the victim once accused, charged, or convicted. Many of these victims fear that by reporting abuse they will be left alone and expected to care for themselves or they will be forced to live in a nursing home.

Many states have implemented mandatory reporting laws to assist in the prevention of abuse, neglect or exploitation of vulnerable adults. Utah is one of the many states to have a mandatory reporting law (U.C.A. § 76-5-111). Utah law states that any person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect, or exploitation shall immediately notify Adult Protective Services or the nearest law enforcement agency. Anyone who makes the report in good faith is immune from civil liability in connection with the report; however, any person who willfully fails to report is guilty of a class B misdemeanor.

It is important to note that the anonymity of the person or persons making the initial report and any other persons involved in the subsequent investigation shall be preserved and may only be released in accordance with the rules of the division (U.C.A. § 62A-3-311). In addition, all investigation information is confidential.

The following is a list of indicators of abuse, neglect or exploitation. It is important to note that the following lists are merely indicators and may not always be violations.

Signs of Abuse:

• Unexplained bruises, welts, fractures, abrasions or lacerations
• Multiple bruises in various stages of healing
• Multiple/repeat injuries
• Low self-esteem or loss of self determination
• Withdrawn, passive
• Fearful
• Depressed, hopeless
• Soiled linen or clothing
• Social Isolation

Signs of Neglect/Self-Neglect:

• Dehydration
• Malnourishment
• Inappropriate or soiled clothing
• Odorous
• Over/under medicated
• Deserted, abandoned or unattended
• Lack of medical necessities or assistive devices
• Unclean environment
• Social Isolation

Signs of Exploitation:

• Missing/”disappearing” property
• Inadequate living environment
• Frequent/recent property title changes or will changes
• Excessive home repair bills
• Forced to sign over control of finances
• No/limited money for food, clothes and other amenities

Prevention can only occur if there is awareness, the statutes are adhered to, and any suspicions of abuse, neglect or exploitation of vulnerable adults are immediately reported to Adult Protective Services and/or law enforcement.

For more information or to report abuse, please visit: http://www.dcf.state.fl.us/programs/abuse/report.shtml

RIGHT ACCORD empowers staff to give back  through volunteer services to serve the community.

Senior Friendship Centers, Inc., established in 1973, is a not-for-profit organization dedicated to helping older adults live with dignity and independence and home instead in Sarasota, Desoto, Charlotte, Lee and Collier counties. Funded in part by State and Federal agencies, and support from private foundations and individuals, Senior Friendship Centers serves more than 10,000 older adults annually.

Located in beautiful Luke Wood Park near downtown Sarasota is the home of Senior Friendship Centers, just at the curve of Mound Street where 301 and Tamiami Trail come together. For more information of  other events and programs please call 941.955.2122 or visit their website at:

http://www.friendshipcenters.org/sarasota/index.cfm?location=sarasota&locID=1

RIGHT ACCORD Client Relations and Human Resources Manager,  Kathryn Larkin, MBA is involved in the fund raising committee. The company and it’s staff are working together to raise auction items  solicit donors for the event.

In response to the increasing need for guardianship services throughout Florida, the Lutheran Services Florida (LSF) Guardianship Program has continually expanded since it was originally founded in 1982. Currently, the program serves incapacitated individuals in Sarasota, Manatee, Hillsborough, Escambia, Santa Rosa, Walton, Okaloosa, Charlotte and De Soto Counties.

The goal of the Sarasota Guardianship Program is to protect some of the communtity’s most vulnerable citizens from abuse, neglect and exploitation while ensuring their quality of life with the dignity they deserve. LSF accomplishes this by being appointed guardian for individuals identified at risk enabling LSF to assess and monitor their ongoing physical, psychological, sociological and financial needs.

For more information or to reach the Lutheran Services Florida in Sarasota,  please call 941.358.6330 or visit their website at: www.lsfnet.org

If you wish to donate auction items or purchase a ticket for the event, please call RIGHT ACCORD at 941.366.0801

At 83 years old, Martha still lived in her own home, and enjoyed working in her garden and canning peaches. It was becoming harder to motivate herself, to get up in the mornings and accomplish the day’s tasks. She confided to her daughter that she felt anxious and tired. Her daughter, who was taking medication for her anxiety, took Martha to her own doctor, not Martha’s and got her a prescription for Valium. In doing so, the daughter’s doctor, who had never seen Martha and who did not have her medical history, was only aware of a few medications they told him she was taking.

Martha, in fact, was taking 9 different medications as well as herbal supplements.

The addition of Valium to her existing list of prescribed drugs sent her to the emergency room with respiratory distress. If she had gone to her own doctor, he would have found that a dosage adjustment of her current medications would have solved her anxiety.

Medication errors are common in the elderly. Many seniors take on average 6- 8 different prescriptions as well as over the counter drugs. Many times the elderly will not go back to their doctor to have their dosage evaluated and changed if necessary. Family members should be aware, that elderly parents may tend to take the family’s advice over going to their own doctor. Even though children want to help increase the health and stamina of their parents, they may in fact be causing damage by misdirecting their loved ones.

Where a younger person can benefit from herbal supplements like Ginkgo Biloba, Saw Palmetto and others, in older people, these herbals may cause adverse reactions with their prescription medications.

In 2003, a panel of experts put together a list of potential medications that would not be appropriate to give to seniors. This is called the “ Beers List ” after one of the research professionals.

Dr. Donna M Fick, R.N. one of the panel members for updating the “Beers List,” states in her article on Seniorjournal.com:

“Just as our bodies physically slow down as we age, changes occur in the way that older bodies handle pharmaceuticals, and this has motivated experts to develop a list of drugs that may be harmful to elderly patients.

“With age, drugs tend to build up in the body, and the distribution and elimination of drugs from the body changes as well,” says Dr. Donna M. Fick, R.N., associate professor of nursing at Penn State. “Many drugs, like diazepam (Valium) and other anti-anxiety drugs build up fast.”

An on-line article on HealthSquare.com , Titled “Drugs and the Elderly,” talks about physical symptoms and medications.

“ Among the first signs that a drug may not be working properly in an older person is a change in mood, energy, attitude, or memory. Too often, these alterations are overlooked, ignored, or chalked off to “old age” or senility. Older people may themselves feel that their blue mood is caused by something external such as the death of a friend or simply by boredom. Nothing could be farther from the truth. Virtually every heart medication, blood pressure drug, sleeping pill, and tranquilizer has been known to trigger depressive symptoms.

When a psychological symptom appears in an older person, examine his or her medication or drug use first. Consider, too, factors like alcohol intake, poor nutrition, and hormone imbalance. And never dismiss the possibility that a real psychological problem has developed and may itself require medication.”

There are many things family members can do to help monitor medications for their elderly parents.

• Make a list of medicines prescribed and all supplements being taken.
• Give this list to the doctor and pharmacist and have one on hand for emergencies.
• Use the same Pharmacy to fill all prescriptions. Pharmacies keep a record of your prescribed drugs and will verify your doctor’s instructions. They will also tell you if foods or over the counter supplements will interact with a prescription.
• Dispense pills in a daily pill organizer box.
• Have a family member be responsible to call or physically monitor the taking of medication

Family members who live long distances from their elders have available to them

new technology in medication monitoring.

• Alarms for pill boxes, watch alarms, medical alarm bands and necklaces that ring a reminder.
• Computerized pill box dispensers that ring a designated number if the pills have not been taken.
• Home Telehealth -

“Technology has developed computer and computer cameras to help the elderly in their homes stay safe and healthy. Home telehealth-set up by medical professionals in the home–enables providers to monitor such things as medications and blood pressure and actually see the patient. Patient questions are answered and advice is given, while the monitoring nurse views through the video phone how his or her patient looks physically.” The 4 Steps of Long Term Care Planning, Pg 92

• Home Care Agencies – Home care companies offer a variety of service options in helping families care for and properly dispense medication to their elder parents.

Overmedication or taking medication incorrectly may lead to early mental confusion and decline in health in seniors. “If medication problems were ranked as a disease in cause of death it would be the 5 th leading cause in the United States”. (from article on LongTermLiving)

Rosemarie Tamunday-Casanova, RN owner and Administrator of RIGHT ACCORD Private Duty-Home Health Care is giving presentations on Medication Safety and Management in Active Retirement Communities. Her last presentation at the De Soto Beach Club in Sarasota, Florida  on August 25, 2010 created a great awareness of the importance of medication management and the key to keeping residents independent as long as they possibly can. http://www.holidaytouch.com/Our-Communities/desoto-beach-club.aspx

RIGHT ACCORD offers medication assistance to seniors who have trouble with medication management. Please call 941.366.0801.