Nursing Homes|Nursing Home Abuse|Assisted Living Facilities

Q. My eighty-four-year old mother is selling her house and moving in with me. Can she purchase a life estate in my home in order to preserve her money in case she enters a nursing home?
A. Yes, under the Deficit Reduction Act of 2005 (DRA), a person who purchases a life estate interest in another's home for full consideration and lives there for at least one continuous year does not face an ineligibility period for Medicaid nursing home benefits. If your mother expects to live in your home for at least a year, she could purchase a life estate in your current home or in a new home, which gives her certain rights to your property, including the right to live there. This provision does not apply to a transfer of property which your mother previously owned.

An attorney can assist you in determining the amount for which the life estate should be purchased, based on your mother's age and the value of the home. The life estate has no value for purposes of determining an individual's eligibility for Medicaid. As the life tenant, your mother has the legal right to live in the property for life or for a specified period without paying rent. Upon her death, the life estate is extinguished.

If you sell your home during your mother's lifetime, your mother would have to sign the deed and a portion of the sale proceeds would be payable to her as the life tenant. Those proceeds would count as her resources for Medicaid purposes.
Q. What if my mother does not sell her house? Can she transfer it to anyone without being penalized?
A. Yes. Transferring the house to the following people would not affect her eligibility for Medicaid:

1. spouse


2. child under the age of twenty-one or a child who is certified blind or certified disabled at any age


3. a sibling with an equity interest in the home who has resided in the home at least one year immediately prior to the date the patient became institutionalized and continues to lawfully reside in the home


4. a caretaker child who has resided in the home for at least two years immediately prior to the date the patient became institutionalized and who provided care.

Q. What if my mother enters a nursing home before she sells her home?
A. If her equity interest in the home is $750,000 or less and she intends on returning home, it will not be considered as a resource in determining her eligibility for Medicaid. The equity value is derived by subtracting encumbrances such as liens and mortgages from the fair market value.

Reverse mortgages and home equity loans can be used to reduce the equity interest. Medicaid law is constantly changing and is subject to various interpretations. Because the DRA is so new, there are many ambiguities and uncertainties. Do not take any action without first consulting an attorney who thoroughly understands the Medicaid rules.

Sadly, approximately 2 million seniors living in the United States have been diagnosed with one or multiple depressive disorders. One of the leading causes of this depression has been linked to a lack of independence. In fact, approximately half of seniors who are living in an assisted living or nursing home facility have exhibited major signs of depression. Although not all nursing homes or assisted living facilities are bad institutions, it is a well known fact that with government cut backs and the rising cost of health care, patients in many nursing homes are not given the proper care to help them flourish and try to move forward with the rest of their life. For the most part, the aim is to keep them quiet, comfortable and alive. This means that they receive nothing more, nothing less than just the required care. Outside recreation, trips to places around town and regular time to themselves are necessary activities to keep a senior feeling happy and independent, but they are typically not part of the regular package of nursing home endeavors. Not being able to go about their days with a certain level of autonomy is a definite way to lead them into a depressed state.

One way to help seniors to regain their independence is to allow them to live at home. However, with the high cost of home health care, and the rarity of being able to have a family member stay at the home full-time, sometimes leaving a senior alone in their home is just not an option. They may have limited mobility, or other health issues that require someone to look in on them regularly. However, their health issues could strike at any time, and if they are alone when this happens, it could have much more dire or even deadly consequences. This will often lead to family members reluctantly placing their loved one in a nursing home or assisted living care facility, not always realizing that there are actually some less expensive options that will allow seniors to remain at home with limited home health care and supervision.

An option to help add more peace of mind to the situation is to invest in a medical alert system. A medical alert system will allow the senior to move about their home and go about their everyday activities with a sense of pride and a lack of fear. If an accident does occur, they will be wearing a medical alert bracelet, necklace or pendant that will allow them to call for help immediately if something were to happen. By having a medical alert system in the home to help seniors regain their autonomy, they will be able to see a rise in their self-esteem and a preserved sense of independence. This is a completely priceless feeling for a senior who may have previously been depressed, stuck in a nursing home, just hoping to make it through the day.

Common Symptoms of Depression in Seniors

Identifying that a senior is depressed is the first step to find out why they are feeling that way. Although a lack of independence is one of the top reasons why seniors suffer from depression, other factors may be involved, so it is important to be aware of the signs and symptoms seniors may face, so that it may become easier to diagnose the root of their issue. Here are some of the most common signs of depression in seniors:

- An inability to sleep for a normal period of time during the night
- Constant sad mood where little-to-no change in mood ever occurs
- Complaining about their physical health constantly
- Contemplation of suicide
- Lack of appetite
- Feeling guilty over the past
- Increased forgetfulness
- Bitterness, Irritability
- Lack of energy
- Crying or tearing up without reason
- Inability to concentrate for more than a few moments at a time

Knowing the common symptoms will make it simpler to identify if a senior is in a depressed state or suffering from extreme depression and then work out that best way to help them move past it.

Lack of Independence As a Leading Cause of Senior Depression

Indeed, a lack of independence is one of the leading cause of depression in seniors. For 75% of those never returned to an independent lifestyle, end-of-life depression sets in which is not at all common in seniors, unless they are actually experiencing a terminal condition. This is a type of depression that sets in for many people when they find out they have a terminal illness and there is not much time left for them. For seniors that are not terminally ill, end-of-life depression has been linked to seniors that are living in nursing homes or assisted living facilities with little-to-no independent activities available to them.

In these cases, it is vital that the senior is moved to another location or brought home. When this is not possible, and the senior has to continue living in a place that takes so much autonomy away from them they might exhibit signs of depression, this is not a good situation. Often, end-of-life depression can lead to the end of someone's life.

The Role of a Medical Alert System in Providing Independence, Reducing Depression

A medical alert system can reduce depression by providing independence to those who use it. If a senior is experiencing depression while in a nursing home or assisted living facility, moving home and regaining their independence is a great way to combat that and help them begin to cope and possibly beat their depression. Sometimes hiring a home health nurse is out of reach financially, so a medical alert system to help provide peace of mind and a regained level of independence is a great alternative.

Nursing Homes are so important to the elderly once their safety, health care, nutritional care and day-to-day living needs are being neglected. There are many Reasons Why Nursing Homes are so important, yet (sometimes) to the elderly person the Nursing Homes are not the places they want to be in.

Nursing Homes Are Important

When an elder person safety needs start to be affected by their own behaviour due to dementia or ailing health then another solution is needed. Be it from home help, family help or even Nursing Homes. Once there are no other options available to keep the elderly person at home then a decision needs to be made to where the best place is for that aged care person.

Safety Of Aged Care People

The safety aspect of an aged care person is important.There are many reasons why staying at home by themselves is no longer an option. Here are five reasons why staying at home is no longer safe.

1. Doors and Windows are no longer being locked giving easy access to the people and contents of the house from the general public


2. The aged care person can no longer recognize when it is safe to answer the door and will let in people who could take advantage of them


3. Other people are able to convince the aged care person to hand over important information such as bank details, or even give access to their money.


4. Valuable items are noticed missing from the house, and when questioned by family members the aged person can not remember where those items are.


5. The layout of their house has rugs/mats and furniture that are placed about the house - in positions that could potentially cause slipping accidents. Or even cause a fall that could result in broken bones.

Nutritional Care

When an elderly person forgets to feed themselves or skip meals then the nutritional needs of that person is not being met. That is one Reason Why Nursing Home Are So Important, because there are three meals provided every day plus morning tea and afternoon tea. Food is important for the older person to keep the weight on, and to prevent illnesses. Once they start to skip meals, or make poor food choices then Nutrition is lacking and will affect their skin, their general health and give to weight loss.

Nursing Homes Provide Health Care

Most (if not all) Nursing Homes provide vital Health Care Services. From Doctors who visit daily, to outside visits to dental care, eye specialist, chiropractor care, specialists and many other Health Care providers. The cost of these services are normally covered with a Medicare Card or under the aged care pension card /veterans affairs card. Yet when an elderly person is living at home by themselves these vital services are forgotten. A good reason Nursing Homes are so important...they have staff that organise these services for the residents.

Day to Day Living Needs

The Day to Day Living Needs are important to an aged care person, from waking up and having a shower, to dressing, having breakfast, cleaning the kitchen, watching TV, washing the clothes, shopping for food, cleaning the house, mowing the yard, driving the car, to visiting friends and even having friends/family over. When those day-to-day living needs can no longer be met then a Nursing Home is able to give help to their Residents. The Lifestyle Co-ordinator is there to arrange such needs as cleaning, feeding, washing of clothes, ringing for taxis, organising outings and assisting with Day to Day living.

There are many reasons Why Nursing Homes Are So Important. It depends on the residents reasons of why they need a Nursing Home, their acceptance of the help that they need and their level of understanding. Once a person reaches a stage where they are no longer able to live safely by themselves, and forget their basic needs then assistance of either home help or nursing care, or a nursing facility is very important.

To read any other Nursing Issues within Nursing Homes visit Nursing Issues.

If it weren't for licensed practical nurses (LPNs), an already overworked staff of registered nurses and nurse practitioners, would find their days even more stressful. LPNs, called LVNs (licensed vocational nurses) in Texas and California can be thought of as those who provide a very personal level of care to the patient.

While they normally work under the supervision of physicians and RNs, their responsibilities increase as they become more proficient. You'll find LPNs taking vitals, monitoring in and out volumes, turning patients to prevent bedsores, treating and/or dressing wounds, providing enemas and much more.

You'll also see LPNs recording vitals, taking measurements of height, weight, temperature, blood pressure, pulse and respiration, giving alcohol rubs, helping patients deal with personal hygiene and providing a friendly face and caring heart as each patient journeys toward recovery.

In the old-time war movies, you'd see wounded soldiers speak of an angel of mercy (meaning a nurse), and while LPNs did not exist in those days; today's LPNs are the ones helping patients on a day-to-day basis, providing the personal care a registered nurse or nurse practitioner might be too busy to provide.

Because state laws vary, you'll find some LPNs administering prescribed medicines, starting IVs, while in other states this may not be part of their job description. Because many patients will finish their convalescence at home, it's often necessary for LPNs to spend time with family members, instructing them in the intricacies of home care for a loved one, providing instructions to family who otherwise might seem overwhelmed.

LPNs and Babies: Because policies often vary from state to state, or in a particular hospital, it's difficult to provide a definitive answer LPN's job description, some LPNs would be involved with assisting in the delivery, care and feeding of a newborn.

While most LPNs will find they are generalists, meaning their work is in various areas of medicine and healthcare, certain LPNs will spend their time in nursing homes, a doctor's office, or home health care. Certainly LPNs have a place in assisted living facilities or nursing homes where they will assist in the evaluating of residents, develop plans of care, and of supervise nurses' aides.

You might find an LPN in a doctor's office or clinic, being responsible for appointments, scheduling flu shots, filing medical charts, etc. LPNs are vital to the smooth flow of the health care profession and without them; RN and NP would certainly find their jobs more difficult. While we've sought to give a general feeling of an LPN's job description, the particulars may be unique to their place of employment.

Remember this as you consider your career as an LPN. Doctors and administrators may be at the top of the ladder, but nurses and LPNs are the heart and soul of the healthcare industry.

10. The government isn't going to pay for long-term care at home, in a nursing home, or in an assisted living center. Medicare pays 100% of long-term care for 20 days and all but $95.00 per day for the next 80 days--after that nothing. However Medicare only pays for skilled care and most long term care is not skilled care.

9. The national average cost for nursing homes is approximately $105.00 per day. Assisted living ranges anywhere from $50 - $90 per day. If you live on the Eastern Seaboard you can easily spend $50,000 to $80,000 for a year's stay in a nursing home. These costs are perfectly capable of wiping out a lifetime of savings-not to mention the emotional effect long-term care has on a family.

8. A Harvard University study showed that 69% of single people and 34% of married couples would exhaust their assets after 13 weeks in a nursing home. 13 Weeks = 91 days!.

7. At age 65, a woman has a one out of two chance of spending some time in a nursing home. A man has a one out of three chance. In the case of men, mortality catches up with morbidity.

6. Medicaid kicks in only after a person's assets and dignity are gone. In many states the eligibility threshold for single people is $1,500 in assets. After all Medicaid is WELFARE.

5. Children would like to help, but children often have children of their own. They certainly can't quit their jobs to care for their parents.

4. Health rarely improves with age.

3. People can't buy long-term care coverage at crisis time or when they are ready to use it.

2. American's have access to the best health care in the world, if they can pay for it.

1. Most People want to choose where they go instead of having to go where they are taken, and if independence is important to them, they will need to have either a big estate or adequate insurance.

Information quoted directly from:

* A Shopper's Guide to Long-Term Care Insurance , National Association of Insurance Commissioners.

* Long Term Care Companion Consumer Guide, Transamerica Occidental Life.

Most senior living facilities have wandering management systems to help ensure the safety of residents afflicted with Dementia or Alzheimer's symptoms. Symptoms that may lead to wandering and Elopement.

The leading causes of death or injury in these situations are:

Exposure to heat or cold
Drowning
Traffic related injuries

Problems that occur and lead to deaths are:

Staff
In my opinion, the most important part of any wander management program is the staff. Different facilities shape their staff's response to an alarm differently. Some facilities only rely on some of their personnel to respond to alarms, while others take an all hands on deck approach. In either case, the responders must be engaged and vigilant. Staff engagement begins with assessments, is maintained with vigilance and ends with responsiveness. Problems occur when this breaks down. These systems can be affected by radio or electrical interference. In extreme cases staff have been known to turn off the system because it annoys them. I have heard of cases where an employee unplugs the system from an outlet to plug in a vacuum cleaner and forgets to plug it back in.

Ask the facility some basic questions. How often do they run drills? How often and how in depth does the facility test the door systems, transmitters and staff? How old is the system?

Then find out about these elements of the system,

Coverage Area
Sometimes facilities simply do not cover all exits at risk. Why? Maybe the facility has never had an elopement, except for that one time. Maybe it's a financial concern. It could be they think the wanderers always go out the front door. In my experience wanderers have a lot of time on their hands, they spend most of it trying to get out unless they have activities to do. If they have that one moment of clarity while they are trying to get out, they will. They may think that a resident would not think to go out the kitchen, storage, chapel or laundry door. Inevitably over time, these are the doors the residents elope from.

System Age
It is a fact some nursing homes still have some doors covered with wander systems from the early nineties. These systems may function but the newer systems work so much better. The newer system have anti-tailgating features, better antennas, more elaborate bypasses. Older systems usually have a two button bypass that have the bypass code keys worn off or are simple enough that the wanderers watch staff or visitors and learn the code. Keep in mind a recently renovated building doesn't mean an updated wandering system. They can be moved from door to door.

Design and Functionality
Is the facility using a system they implemented ten years ago? If the system was put in ten years ago does the design still relate to their staffing levels or foot traffic flow. Do they give bypass codes to visitors or delivery drivers.

These are just a few of the top concerns you may want to investigate when putting your at-risk family member in a home. Not all wandering prevention systems or plans are created equal.

Making a choice to live in a nursing home is not easy. It can be an overwhelming emotional decision.

A nursing home can provide care that an individual cannot provide on their own, so whether you are making this decision for yourself or others, it is not a decision to be made lightly.

You need to do careful research, so that you can make an informed decision. Making a decision as big as this one is simply best not done in haste.

If you find one that you like, there is no guarantee that you can get in immediately. Waiting lists do exist for many of the better facilities.

The first step in choosing a good nursing home is to ask your doctor and a hospital social worker. They may be able to provide you with a list of homes.

The next step is to ask your friends, family, former co-workers, and church members (any other persons in your social network). They may be able to provide you with personal experiences that may not be available in any written report.

The third step is to visit homes that seem suitable and are located conveniently. On your initial visit to the home, take with you a written list of questions you want answered (if the questions are in written form, you won't tend to forget to ask questions that are important to you). Don't be afraid to ask these questions of the staff, the nursing home administrative staff, and the residents.

The questions should include:

1. Is the staff friendly? Do they appear to get along with each other?

2. Do the staff and residents interact well?

3. Do the residents appear clean? Is their hair neatly combed (brushed)? Are they clean - shaven?

4. Do the residents appear to interact with each other and take part in the activities?

5. Does the home appear to be clean? Are there any unusual smells? Is there an odor of heavy disinfectant? (perhaps to mask less pleasant odors)

6. Is the neighborhood safe? Would I feel safe taking a walk around the outside?

7. Are there any fresh plants or flowers?

8. Is the furniture comfortable and in good repair?

9. Are the calendars and clocks up to date and in working order?

10. Are the hallways well lit? And do they appear to be wide enough for wheelchairs and people to pass each other comfortably?

11. Are there activities and crafts that I would enjoy?

12. Is there a minister (rabbi or other religious leader) who visits the home and is he/she available to pray (or talk) with?

13. Is the dining room arranged to allow easy access to residents with wheelchairs?

14. Is the bathroom clean? Does the bathroom have handicap available items such as grab bars and handrails?

15. Is the shower/bath area clean? Are there nonskid mats available?

The mere mention of a hidden camera can invoke thoughts of less than honorable people using hidden cameras in less than honorable ways. But despite the news reports of the misuse of them, one recent story of elder abuse in Haverford, Pennsylvania in April of 2012 lets us know with certainty that a hidden camera can be an invaluable tool for concerned family members.

So how can you tell if your elder family member is being abused? What can you do to help? What resources are out there? And if you're pondering whether or not you need to buy a hidden camera to protect a loved one consider the following.

According to the American Psychological Association more than two million older Americans are victims of elder abuse every year. Research suggests that elder abuse is significantly under reported and under identified. In fact, as few as 1 in 6 cases of elder abuse come to the attention of authorities, according to the National Center on Elder Abuse.

Elder Abuse is defined as intentional or negligent acts by a caregiver or trusted individual that causes, or can cause, harm to a vulnerable elder. Sharon Merriman-Nai, the co-manager of the National Center on Elder Abuse has stated that "Unfortunately from what statistical information we do have, most victimized people are abused by people they know and trust". Elder abuse can come in many forms; it's not just physical abuse, neglect, abandonment, psychological or emotional abuse, financial abuse and exploitation and even sexual abuse fall under the definition.

Many victims are reluctant to report abuse and the greatest difficulty is overcoming their resistance and fear of identifying the problem, so it's very important that you watch for signs of elder abuse. Often the best help that you can give is to ask questions, of your elder family member, their caregivers and even yourself.

A change in general behavior is a universal warning sign, if you notice that your elder loved one becomes withdrawn or now gets upset or agitated easily, it might very well indicate that it's time to start asking questions. And one important thing to remember is that if your loved one says something happened, take them seriously, Ms. Merriman-Nai also said "Sometimes, when older people suffer from dementia or some sort of cognitive problem, they may not be believed".

If you notice any untreated injuries, or an injury that seems inconsistent with the explanation given for its cause, it may be a sign of physical abuse. Also try to determine if your older family member is afraid of anyone, whether at home or in a facility, or whether they have actually been hit or slapped.

Greed is a contributing factor in many cases of financial abuse; the elderly may be susceptible to exploitation. Be observant, look for signs of missing personal belongings or credit cards, unusual bank account activity or checks made out to cash. Has your loved one redrawn their will at a time when they seemed unable to write one?

Emotional abuse can range from name calling to intimidation and threats. Ask them what happens when he or she and the caregiver have a disagreement. Are they being treated like a child, humiliated or threatened with punishment? Reluctance to talk about their relationship with a staff member, or demonstrating fear, anxiety or withdrawal when asked may be signs of emotional abuse.

In regards to the Pennsylvania caught on hidden camera incident, Delaware County District Attorney Michael Green said "The video depicts criminal activity directed at a senior victim in our county, it's abusive and it's the humiliation which is most difficult to watch on the video. No senior resident of a facility should be subjected to that kind of behavior, particularly from a health care provider".

There are many styles of hidden cameras available that can be discretely placed to blend in with the normal decor of a room, but be aware that although a hidden camera is a great tool for discovering the truth about the alleged abuse, it's not the only solution. With or without video evidence, if you have any reason to believe that an elder loved one is being abused or neglected, there are other resources to help. You can visit the National Center on Elder Abuse website at http://www.ncea.aoa.gov, for more ways to help your loved ones.

And if you believe that an elder is in a life threatening situation, call 911 or contact your local police department immediately.

Nursing is a discipline of the medicine sector. It focuses on assisting individuals, families, and communities in attaining, re-attaining, and maintaining their optimal health. Nursing is a science or art that focuses on offering quality healthcare to persons and their families throughout their lives.

There are many options available in nursing for those who want to pursue nursing as a profession. Nursing is a very diverse field and offers many different sectors to work in, such as, people can work with hands-on patients or they may work in a lab or a research facility, or they may go into the teaching field to guide and educate students. This field is very vast and people can opt for any option as per their interests.

Nursing has many applications in modern day medicine. Nurses can do their specialization as Registered Nurses (RNs), nurse practitioners, head nurses or nurse supervisors, Licensed Practical Nurses (LPNs), home nurses, home health nurses, hospital nurses, office nursing, or nursing aides. Each specific type of nurse has a different set of responsibilities to perform.

The Nursing profession requires a great deal of patience, as well as the ability to provide comfort and care to their patients. They have to perform several duties such as provide appropriate health care services to patients including clinical assessments, treatment, diagnosing medical conditions, assessing emergencies, ordering diagnostic studies, prescribing medications, leading cardiac arrest codes and documenting medical care.

There are many nursing schools, which provide nursing education. Nursing schools provide considerable clinical experience under supervision, which is typically provided in various departments of a hospital such as maternity, pediatrics, psychiatry, and surgery. Some nursing schools also offer clinical experience in nursing homes, public health departments, home health agencies, and ambulatory clinics.

There are various job opportunities for nurses in many different departments. Mostly nursing jobs can be obtained in hospitals, while clinics, home healthcare agencies, nursing homes, nursing schools, temporary help agencies, and government agencies too provide various openings.

Nursing jobs are in high demand nationwide and earn a high range of salary. Salary range varies as per the specialization and field of work. A nursing career also offers other benefits including a flexible work schedule, a short workweek, and tuition reimbursement as well.

When caring for an elderly parent or relative, there may come a time when their health conditions require that they be placed in a skilled nursing and rehabilitation facility. This is typically the time when most people begin thinking about the inner workings of a nursing home. The interdisciplinary nature of caring for patients in a skilled nursing facility makes for a complex coordination of tasks. The ultimate goal, however, is to help each patient meet the challenges of their personal healthcare plan.

Skilled nursing patients in need of health services or rehabilitation may opt for long or short stays in a nursing home. Family and friends may visit their loved one in the nursing facility as the patient progresses on his or her rehabilitation plan. If the patient is ill then he or she may be provided IV medication or put on hospice care. The nursing staff provides continuous care for the resident patients and completes other medical services at the request of each patient's physician.

Persistent health problems and illness can become very serious as a person ages. Surgical procedures can also require physical rehabilitation, in the case of hip and knee replacement surgeries. The staff at a nursing home are well trained and interdisciplinary. These highly trained individuals must work together on personalized patient care plans. The nursing and rehab teams must be able to handle a wide variety of healthcare procedures. Skilled nursing facilities care for their patients around the clock. Accurate patient documentation must be maintained throughout the process. This ensures that the next group of staff members remains up to date on how patients are progressing.

The state Department of Health and Human Services regulates nursing facilities in the individual state that the facility is operating in. The state regulations require that the nursing facilities pass various tests in order to remain operational. The facilities are tested for quality of care and cleanliness among other things, like patient documentation. Higher rated facilities gain more local credibility.

Assisted living facilities and home care options are not best suited to provide proper care for complex health issues. Falling risks and diseases like Alzheimer's, dementia and diabetic complications are more appropriate for care in a nursing home.

A nursing rehabilitation facility typically provides, wound, dementia and diabetic care, IV medication, pain management. Rehabilitation services like, Speech, Occupational and Physical Therapies are also made available. A nursing facility will also provide social services and activities along with necessities like, laundry service and basic transportation.

All residents are professionally assessed and an individual care plan is developed. Every employee at a nursing care center must provide compassionate care. With the support of all nursing and rehabilitation staff, every patient should be inspired to reach their goals.

Everyone likes to watch birds at a feeder. Who can resist the sight of a black and white chickadee extracting the kernel from a sunflower seed? Or the delicate beauty of a bright yellow goldfinch perching at the feeder? But there is one group of bird watchers who particularly enjoy watching life at the feeder.

Nursing home residents around the country get tremendous pleasure from watching birds. In West Virginia, residents benefit from the dozens of feeders built by the state's Nursing Home Bird Feeder Project. Voluntary contributions by Kansas state income tax payers support wildlife projects through the state's Chickadee Checkoff Program. The nursing home program has given hundreds of bird feeders to nursing homes in Kansas.

An Ohio grade school builds feeders for nursing homes and donates them as holiday gifts. Local hardware stores donate the supplies, making this a real community project. A chain of stores that sells wild bird products offers bird feeder recycling: anyone who brings in an old feeder gets a discount on a new feeder. Store staff clean up the recycled feeders and give them to nursing homes, along with a five-pound bag of food.

In fact the feeders are so popular at some homes, residents organized bird watching clubs to learn more about the birds and share their enthusiasm with others. They invite local bird watchers to give talks about birds and show slides of the bird watching trips. In turn, local bird watching clubs invited residents to join their bird watching trips. An increasing number of accessible trails and viewing platforms make bird watching possible even for people in wheelchairs. And for those people whose mobility limitations restrict them to the car, who says you can't watch birds from the car?

Several nursing homes have extended the bird-friendly facilities to include bird hoses and birdbaths. At one nursing home, residents decorate houses for bluebirds and purple martins.

Hummingbird feeders are perhaps the most popular type of feeder. Slender translucent red tubes contain sugar water, which the tiny birds sip. Suction cups attach tube feeders to windows, so people can enjoy the quick movements of the colorful hummingbirds even from their beds.

Nursing home managers recognize the definite advantages of attracting birds to their residences. Bird feeders bring the dynamic natural world into the slower world of the nursing home. The colors, movements, and sounds of birds appeal to the senses. Bird identification stimulates the mind and provides opportunity for sharing and discussion. For those who are able, filling and cleaning the feeders are useful and rewarding tasks.

Giving to and taking care of others is a precious part of life. Taking care of the birds helps residents feel part of the flow of life, a feeling that too often gets lost in places like nursing homes and hospitals. Bird feeders give pleasure to nursing home residents and residents give sustenance to the birds--a true win-win situation. The new trend of installing bird feeders at nursing homes brings new meaning to the phrase, "It's for the birds."

Nowadays, as nursing profession has become innovative and flexible, nurses have been able to get new ideas, learn, and expand beyond their traditional roles. Since nurses have inherent talents, knowledge and abilities through the rigors of their nursing education, they have started to think outside the box and freed themselves from external restrictions. Their persevering spirit to accomplish greater things has motivated them to advance their degrees, start and grow their own business, join healthcare projects, and hold executive roles in the field of health care. Their ability to lead and innovate enables them to venture a new nursing experience, the nursing entrepreneurship.

Just like in other business, being a nurse entrepreneur can be achieved in a step-by-step basis. You cannot simply be a successful entrepreneur overnight. You have to have sufficient training experience and perseverance in order to grow and thrive as a nurse entrepreneur. Here are some tips on how to become a successful entrepreneur:

1. Practical Approach to your Business

If you're planning to start a business as a nurse, you have to think twice or thrice before venturing to this field. Entering a business of course entails investment and money so you have to be very sure and dedicated before establishing a business. Also, if you have started one, you have to innovate in whatever you do and discover the latest ideas in the field of nursing. You have to be a good leader to gain the respect of the people working for you as well as the trust of your clients. You have to develop your skills and knowledge, and you have to prove that you really take good care of your clients.

2. Starting up your Business

Do not start a business or any undertaking without preparation and planning. You have to think of all the things that could be relevant to your business, like the initial investment, the time you will need to establish your business, the target population of your business, the timetable you will pursue to regain your investment, and the necessary expenses such as purchasing of business equipments and advertising expenses to promote your business.

3. Be Optimistic

Always look at the positive side of things and do not lose hope when it seems that your business does not profit. Also, when you are planning, always have a persevering spirit that would prompt you to innovate and lead in your nursing field or even in other fields. Believe in yourself and always think that you have unique talents and capabilities to accomplish greater things.

4. Fall back alternatives

Just in case your business does not succeed, do not lose hope. Thinking of other alternatives for your business does not meaning being negative, but would mean being practical. Face the reality that not all businesses succeed and take it as a chance to innovate, redefine your business, and further expand your roles. Besides, you have many other options as a nurse. You can be a teacher, a public speaker in conferences, a researcher, and a consultant under medical field, among others.

Of course, being a successful nurse entrepreneur could give you much advantages and benefits. Here are some:

1. Many Opportunities

Since being a nurse is the most in demand profession in many countries nowadays, being a nurse entrepreneurship can be a plus especially when you are working in hospitals and other health sectors. Since you have proven innovative skills and knowledge in entrepreneurship, nurse entrepreneurs are much more very welcomed in their medical field.

2. Flexible Roles

Having started a business as nurse, you have proven to be a leader to the people working for you. You also have all the authority to delegate people and adjust working time and schedule. As a result, your role as an entrepreneur becomes really flexible. Because of that, you still have more time to work other than your business like being a nurse in nursing homes for adults, maternity homes, and other medical facilities.

However, when starting a business, you still have to take into account things other than the advantages of entrepreneurship. You should take heed of certain disadvantages and possible problems that may occur when establishing a business.

1. Nursing Business Needs Experience

You have to remember that managing and handling a business needs enough experience. Do not venture into any kind of business if you are not 100% sure of what you're going to do. If you know someone who has already run a business that matches yours, you can team up with him or her to ensure a more firm and stable business.

2. Funds

Of course, you cannot start a business without money and capital. Make sure you have enough funds to offset any shortage that may occur and to pay future expenses you will need to improve your business

Travel Nursing: A Unique Career Path for Nurses

Aside from being an entrepreneur nurse, another possible option for nurses is travel nursing. As the name implies, travel nurses are nurses who travel a lot and go to new and different locations to provide their service to their clients. Since this job is highly compensated and could give some a unique life experience to travel in many places with all the travel, housing, as well as health and malpractice insurance and costs paid, travel nursing has become an alluring career path for many nurses.

If you're thinking of shifting into this career path as a nurse, here are some things you need to consider first:

• The hours, responsibilities, required skills and salary- If you do not want to regret in the end, you have to know these things before signing any contract.

• Network roles - Contact other travel nurses you know and ask them about their experiences in their work. You can also inquire to the most credible travel nurse agencies in you location about the nature of travel nursing.

• Your dedication to get the job - Traveling could be enticing since you will be able to see new places; however, also consider your comfort and convenience with short assignments and frequent change of residence.

• Weighing options - If you're still unsure about travel nursing, you can consult a healthcare staffing agency to enlighten you about the pros and cons of this nursing career. Tell them your options, your motivation, your hesitations, as well as the benefits and disadvantages you consider about travel nursing. Doing so may help you make a decision about this new venture.

Given the enormous volume of information written about home care services, I continue to be amazed at the frequency with which skilled home health care is conflated with non-medical home care, as if they were similar concepts. Some authors even use the terms interchangeably. Nothing could be more off the mark. In this article, I would like to make clear some of the key distinctions between these two kinds of home care.

Skilled home health care is virtually always provided by Medicare-certified agencies and is covered by Medicare and commercial health insurers. The services consist of intermittent visits by skilled professionals, usually a nurse and/or a rehabilitative therapy professional-physical therapy, speech therapy or occupational therapy. Visits take place intermittently over a limited period of time lasting no more than a few weeks, usually initiated after a hospital or nursing home discharge. In conjunction with skilled services, a home care aide may visit once or twice a week for a brief visit to provide in-home assistance with personal care, such as bathing.

Medicare covers skilled home health care under the following conditions (commercial insurers usually adopt the same criteria): 1) The services must be prescribed by a physician; 2) They must be provided by a Medicare-certified home health agency; 3) The patient must be home-bound, a requirement that is loosely defined; 4) The patient must need the care of one or more of the professionals mentioned above, as certified by a doctor.

Now, the eligibility criteria and insurance coverage of home health care have certain implications for consumers that are not always explained. First of all, the patient and family rarely have any role in choosing the agency they prefer. That decision is in the hands of the doctor in conjunction with the hospital or nursing home. Sure, a patient can express a preference for a particular provider if he or she has had a previous experience with home health care, but this is unusual in practice. Fortunately, Medicare has begun to make comparative information available on the internet through the Home Health Compare database. This may help to shift some control back to the consumer over time, because it permits patients and families to obtain quick information within the limited time frame permitted by discharge planning.

The second implication for consumers is that the frequency of home visits and the duration of home health services is also largely out of the control of patients and families. It is the home health agency, governed by the physician's orders and Medicare's eligibility requirements, that makes those determinations. And, just to be sure that the home health agencies can't profit unreasonably from more and more services, Medicare typically pays them by the episode of care, not by the volume of services they perform.

Non-medical home care is a completely different animal. Companies that provide such in home caregiver services employ unskilled personnel, variously called certified nurse aides, home caregivers, home health aides, home companions and other designations. The caregiver services they perform include help with personal care, such as bathing, toileting, dressing and mobility assistance, as well as general companionship, safety supervision and various household tasks. Typically each visit is several hours in length, and many highly impaired care recipients require round-the-clock or live-in care. Conceptually, non-medical home care can be thought of as "assisted living at home." The care recipient is usually referred to as a client, reflective of the consumer-controlled nature of non-medical home care. Unless the client meets the low-income criteria to qualify for Medicaid, this type of home care is almost always paid out of pocket or by long-term care insurance. Clients select the company that provides the care and can fire the company if dissatisfied.

Here is a summary of the key factors that characterize skilled home health care:

• Requires a doctor's prescription


• Nursing, therapists, social workers


• Patient must be house bound


• Performed by a Medicare-certified agency


• Limited visit frequency and duration of services


• Consumer usually not in control


• No sustained presence in the home


• Covered by Medicare or health insurance


• Providers paid by the episode of care


• Accountability to doctor and insurer (Medicare), not just to patient

And here are the ways non-medical home care is different:

• No doctor's prescription required


• Home companions, nurse aides, home caregivers


• Irrelevant whether client is house bound


• Agency does not need to be Medicare-certified


• Length of visits and duration of care determined by client and family


• Consumer in control


• Sustained presence is central to the service: "assisted living at home"


• Not covered by Medicare or health insurance


• Providers paid by the hour or by the day


• Accountability to the client and family

n assisted living residence is a facility designed for senior citizens or persons with disabilities who need help with some activities of daily living (ADLs). These people may need assistance with things like managing their medications or taking a shower or bath, but they do not need the 24-hour care and supervision provided by a skilled nursing facility. In Texas, assisted living facilities (ALFs) are licensed as personal care facilities. By Texas law, facilities that provide services to 4 or fewer people do not need to be licensed; facilities that have a census larger than 4 do require a license.

The first ALFs opened in the 1980s, when the United States was dealing with an aging, but basically healthy, population who did not have family nearby to help meet the few care needs they did have. These people resisted going into nursing homes, which at the time offered only limited privacy and personal choice. ALFs usually provided people with private rooms or apartments; social activities and outings were available but not mandatory.

ALFs currently provide homes to over 1 million United States residents. Of those, slightly less than half suffer from diseases that cause cognitive impairments such as Alzheimer's or vascular dementia. In Texas, there are currently 830 licensed personal care facilities and over 4000 facilities that are unlicensed.

An assisted living residence provides customers with a room and with three nutritious meals every day. In addition, the facility also provides staff to help with activities of daily living. Common needs include help managing one's medications, performing personal hygiene tasks such as bathing, getting dressed, and going to the bathroom. Some residents may also need help with activities such as transferring from a wheelchair and eating.

Most facilities figure costs by charging a basic rental rate. They then add on "points" depending on how much assistance the resident requires. Each point costs extra money per month. For instance, a woman who lived in a studio apartment and only needed help with medications would pay less than a woman who lived in a studio apartment and needed help with medications, bathing, dressing, and eating.

In Austin, Texas, the average base cost to live in a personal care residence in $1500. When you include assistance with care, the cost rises to about $2000. This is still less than a skilled nursing facility which typically charges anywhere from $3000 to $4000 per month.

Although some 90% of ALF residents nation wide pay for their care out-of-pocket, Texas was one of the first two states to pass legislation allowing Medicaid to cover the cost of an assisted living residence through its Community-Based Alternatives program. This program helps over 20,000 Texans who would not be able to afford assisted living care otherwise.

Texas has also set standards to determine when an assisted living residence is no longer an appropriate placement for an individual. In order to remain in an ALF in Texas, patients must be able to understand emergency instructions and assist in their own evacuation in the event of a fire or other emergency. ALF care is also no longer appropriate if a resident needs 24-hour care and supervision or requires invasive procedures such as tube-feeding or IV medications.

The cost for ObamaCare has many Americans trying to understand how we can foot the bill. It will connect millions more Americans to a sickness industry gone wild. States are realizing that the mandates within the legislation will force them to spend money through the Medicaid program that they do not have - and unlike the federal government states don't have a Monopoly-style printing press. States are now making the effort to fight ObamaCare in court on points of constitutionality. I have an additional idea for the states that is certain to work: disband all the medical licensing boards. At once the runaway costs of the current health system as well as ObamaCare would be stopped, the quality of care would improve, the suppression of health-option competition would be eliminated, and a new Golden Era of healing would be ushered in.

Those clutching desperately to undeserved power and profits will cry fowl and warn of danger to the public health. Their arguments are shallow and worn. Truly criminal behavior by doctors, such as sexual abuse, can readily be dealt with by the regular court system. Standards of training and competency for the most dangerous of medical procedures, such as surgery, can be maintained by an alternate system of certification.

The fact of the matter is that medical licensing boards have forced a brand of Big-Pharma medicine on the American public that does not produce the result of health for a majority of people participating. To the contrary, millions are injured every year while costs skyrocket. It should come as no surprise that President Obama struck special deals behind close doors with the key players involved: Big Pharma, hospitals, and the AMA. Yes, the states do have the power to change everything by freeing themselves of the monopolistic rules and fraudulent practices behind the excessive use of drugs that is costing so much money. The federal government can do absolutely nothing to stop them. Without the licensing boards the whole fraudulent system comes tumbling down.

The Failing Paradigm of Western Medicine
Every American appreciates the ability of Western medicine to help them in a time of true need. Accidents, injuries, surgeries, acute illnesses, and other aspects of health will always be assisted by Western medicine - as appropriate. And wouldn't it be nice if your doctor was actually free to help you with your health concerns rather than cram drugs down your throat.

The drug-based theory of Western medicine fails miserably in the prevention of disease and in the treatment of many common health problems faced by Americans ranging from depression to obesity, bone health, diabetes, and heart disease. There is a reason Americans pay twice as much for health care with far less to show for it compared to any other economically advanced country: our system is riddled with rampant fraud in the day-to-day practice of medicine.

The highly profitable Big Pharma-promoted scheme of an endlessly prescribed cocktail of over-priced drugs is all but dead - taking with it several hundred thousand Americans every year that are killed by its reckless application. Millions more are seriously injured requiring emergency treatment. Tens of millions find themselves consuming an ever-expanding list of dangerous drugs that do little more than suppress some of their symptoms, change numbers, and cause new undesired symptoms and health problems. As aging baby boomers look more critically at a system of health their parents trustingly accepted, the glaring lack of results casts a cloak of suspicion over a profession once revered.

In the early decades of the 20th century the quick-fix invention of antibiotics sealed the fate of the naturally-minded eclectic physicians, setting back principles of natural health an entire century. Today, 48,000 Americans are killed every year by superbugs that have resulted from the overuse of antibiotics.

In the past decade numerous high profile medication disasters have irreparably ruined the image of the Western medicine brand. The first tremor to shake the foundation occurred in August of 2001 when the statin Baycol was pulled from the market after it was found to be injuring and killing excessive numbers patients.

Then, in July of 2002, a major magnitude earthquake rocked Western medicine. It was found that doctors had been seriously injuring and killing their patients with estrogen extracted from horse urine and synthetic progesterone. Data coming from the Women's Health Initiative showed that this abnormal hormone drug combination increased the risk of invasive breast cancer by 26%, strokes by 41%, heart attacks by 29%, blot clots by 100%, and total cardiovascular disease by 22%. Based on the 6 million women taking these drugs in 2002 (2 billion in sales), the data suggested that during only one year there were an extra 4,800 cases of invasive breast cancer, 4,200 heart attacks, 4,800 strokes, and 10,800 blood clots - including 4,800 life-threatening blood clots in the lungs.

Numerous aftershocks followed: the painkiller Vioxx was estimated by FDA safety expert and whistleblower Dr. David Graham to have killed at least 55,000 Americans from heart attacks and strokes. Bayer's heart bypass surgery drug Trasylol killed at least 300,000 people around the world including more than 20,000 Americans after the FDA knew it was a killer (while Bayer lied point blank to the FDA to hide dangers). A widely prescribed diabetes drug, Avandia, was found to increase heart attack risk by 43% in a patient population already at high risk for heart attacks (and still remains on the market).

The common use of antidepressants was found to be based on a fraudulent portrayal of benefit, when the facts show they are no better than placebo for the majority of people taking them. In fact, their use has been linked to an increased rate of heart disease and was recently linked to a 67% increased risk of death. The blatant poisoning of disadvantaged children, elderly in nursing homes, and now our military personnel with the off-label use of atypical antipsychotics has caused early death, obesity, and Type 2 diabetes while placating stress-related symptoms. It's also worth billions to Big Pharma at mostly taxpayer expense and state Medicaid.

The recent ACCORD trial has now shown beyond any doubt that the aggressive use of medications to change numbers in Type 2 diabetic patients so as to reduce cardiovascular mortality is a complete failure, either resulting in increased rates of death or far poorer health. In other words, the paradigm of Western medicine is unable to fix a problem at epidemic levels in America.

Bone drugs given to prevent osteoporosis are now shown to cause spontaneously breaking bones with long term use. And the statin drugs, the true kings of fraud, continue to speed accelerated aging and health decline in the tens of millions of Americans gullible enough to take them.

These are just some of the drug debacles, there are many others. At this point in time there is no reason for any person to trust anything a doctor tells them to take on a long-term basis in the name of health. Indeed, it is common knowledge that the FDA, which has failed to demand after-market safety testing on approved drugs, has no accurate idea of the true risk profile or effectiveness of any medication, including every blockbuster drug in regular use.

The common thread in all these situations is FDA blessings of the treatments by FDA bureaucrats, typically ignoring the warnings of FDA safety scientists. The dysfunctional FDA culture is often in a revolving door with the industries it is supposed to be regulating - to the extreme detriment of the health of Americans. Furthermore, all of the above mentioned drug scams include blatant illegal marketing activities by drug companies using a variety of strategies including ghostwriting studies, making up fictitious studies, bribing doctors, blacklisting naysayers, manipulating research universities, and major promotion of off-label use. The American Medical Association (AMA) is responsible for enforcing the drug sales through its licensing boards, which ensure doctors do the prescribing or else their livelihood is threatened with license revocation. It is a known fact that most doctors live in fear of their licensing boards.

A Brief History of Medical Licensing Boards

The roots of the AMA trace back to a meeting held in New York City in 1846. Twenty-nine elite doctors of the time wanted to establish a monopoly for their brand of medicine - what was to become Western medicine. Of course, the best possible monopoly is one enforced by the government. By the 1870s the AMA was having success within states at setting up medical boards under the fa癟ade of consumer protection. Their actual agenda was to eliminate all competition. AMA members manned state boards with police powers to enforce their decisions. This way they could exclude any practitioner from their group who didn't practice their way as well as legally go after any practitioner doing anything other than their approved concepts.

By 1912, a complete medical monopoly was in place as the AMA, state boards of medical examiners, and a Federation of State Medical Boards to coordinate their activities was established. In essence this created a fascist merger of state and health-delivery power. Over the next several decades this abuse of power was wielded against the eclectic physicians, shutting down all their medical schools and wiping them out. Today it is wielded against homeopaths, midwives, chiropractors, nutritionists, and alternative health practitioners of all types. And very importantly, the power is used to keep all their members in line - which means prescribe costly and dangerous drugs in ever-increasing dosages to an ever-expanding target list of patients or lose your professional status and ability to earn a living. Who suffers? You - and now with ObamaCare the states are in real trouble.

Resurrecting Medical and Health Freedom
In order to restore health freedom and healthy competition in the health-care marketplace we actually need to remove police-force control, which is an impediment to the free market finding health options that actually produce the result of recovered or maintained health. Oddly enough the primary barrier to such improvement is the medical licensing boards of the states.

The first states to take action in this regard will be the big winners as doctors from around the country will flock to those states, like our founding patriots fleeing the tyranny of Great Britain. They will begin to practice medicine based on getting results and openly compete and cooperate with many other healing modalities. Other states will quickly follow as both doctors and people move to the states with the best system of healthcare - the system that actually makes people healthy.

States need to get a better handle on what is going down in America. State Attorney Generals and Governors need to side with the people of their state and strike a blow to the vast array of organizations that rely on the police power of the licensing boards to maintain an unhealthy and costly health business in America. In case you are wondering that includes HMOs, health insurance companies, Big Pharma companies, large pharmacy operations, chains of hospitals, along with the AMA. Rest assured the powerful lobbies of these groups will fight tooth and claw to keep their corrupt system in place.

If doctors are to be spared the indignity of appearing as little more than drug-pushing puppets squeezed by government-run health care, then we must remove the shackles from their hands - and from the hands of all other health practitioners.

States can control their own financial destiny while improving health care. They can do it by shedding the monopoly rooted in the medical licensing boards. All it will take is a few states to blaze a path and then the floodgates will open. Health freedom should be the rallying cry for any American interested in reducing health care costs while improving health care quality.

Looking out for a nursing home administrator job? Keep in mind that it's not going to be 'smooth sailing' all through. It can turn out to be a decently remunerated employment opportunity and the chances of getting into a good health care organization are also good because as you will see, the turnover in this profession is quite high. This is solely due to the greater demands in this field. In fact you can rightly call it a 24hr responsibility resting on your shoulders.

First of all there is the need for adequate qualification on your side to ensure that you get the position of a nursing administrator. Of course graduation is a must in addition to a degree in health care administration plus some experience of working in a medical environment is a must. A thorough understanding of medical coding and terminology is an essential factor. Some countries require you to take a test and obtain a certificate before they take you in for a Nursing home administrator job.

The nursing administrator is vested with numerous responsibilities covering almost areas of management in the organization. Right from providing counseling services to clients as well as staff, he/she is expected to run the institution within budgetary constraints, see to the staff training and patient welfare programs and fulfill the role of a supervisor in totality. All the staff recruitment is done by the administrator. Cleanliness, upkeep and maintenance of the nursing home come under his/her duties and patient grievances and suggestions are to be handled as well.

Most of the inmates of the nursing home are likely to be there for long term care, therefore the administrator sees to it that their stay is rendered comfortable and pleasant and charts interesting programs for them to stimulate and motivate their unsettled minds. Occupational therapy, physiotherapy, consultation with a psychologists etc are activities that can provide some alternate indulgence for the inmates.

A great deal of patience and discipline is required in carrying out a nursing home administrator job. Every management will run a background check on the applicant before qualifying him for the position because a person with 'questionable' reputation may not be suitable to shoulder the heavy responsibilities of the job. Work experience in a hospital environment and a clean conduct certificate can certainly qualify an applicant.

Mostly, the nursing administrator will be expected to board at the nursing home or else in close proximity since the demands of the job are such that he might have to be summoned at odd hours. Therefore only those who can afford to contribute such hours need take up such a job.

With so many different nursing programs and degrees on offer it is sometimes difficult to differentiate between a Licensed Practical Nurse (LPN), Registered Nurse (RN), and a Certified Nursing Assistant (CNA). Quite simply, a CNA is someone who helps patients with healthcare needs under the supervision of an RN or an LPN. Issues of liability and legality prevent the CNA from performing certain procedures.

Role and duties of a certified nursing assistant

A nursing assistant's duties will vary depending on where she works. Laws vary from state to state and what is allowed for a registered nursing assistant in one state may not be allowed in another state.

CNAs have the chance to work in a variety of settings such as nursing homes, adult day care centers, assisted living facilities, personal residences, and act as liaisons between the RN or LPN and the patient.

The CNA in many cases serves as the RN or the LPN's ears and eyes.

Some of the CNA's duties include providing basic needs for patients of any age, gender, ethnicity and work under supervision. As they have close contact with patients they provide vital information about the patient's condition to their supervisors.

The workload can become intense and stressful, but many CNAs state that the job is rewarding and that they have a desire to care for people.

A successful CNA is one with good people skills and one who engages well with patients. Being a team player is an especially valuable trait.

Training programs are offered by the Red Cross, community colleges, online nursing schools and medical facilities. Many schools offer training within medical facilities as part of the course program. This allows the students to stay focused and also gives them hands-on training. All CNAs are required to take an examination before they can start work.

The demand for CNAs is high among institutions which provide quality care for the elderly. People at health care facilities recognize the importance of a qualified and compassionate CNA and how it can positively affect patients.

A CNA can find support through organizations such as the National Association of Health Care Assistants. Remember every state is different as far as the amount of time required for training and the type of environment where you would like to work. Before starting your CNA training, contact the State Nurse Aide Registry and/or State Licensing Board to enquire about their requirements - especially about the state in which you want to work.

Finding a college where you can train for a CNA is easy. Go online under the heading nursing colleges and fill in your degree subject and other details and a list of colleges will come up for you to browse and choose from. They all have similar nursing programs although the titles might not all be the same. Have a notebook and pen ready to make notes. Check out the eligibility requirements. Check to see what paperwork and documents you need to fill out your application. Remember to check out programs in your own state.

Nursing home is the place where extra attention is taken care of by the highly skilled nursing and care unit to ensure that the patients get that extra attention and care they needed the most in order to get cured at a faster pace.

But, my friends, in this word where taking care and helping the ones in need is considered as an extra burden, several nursing homes don't show of the proper care and affection that are seriously required from them.

So many news and events do come out at the newspapers that show and ensures us about the medical negligence occurring at the nursing homes and abusing of patients by the nursing home units and staffs.

It has also been observed that the maximum number of malpractices and medical negligence always occur the most in these privately owned nursing homes. Wrong predictions of diseases are a very frequent thing that occurs at these so called the most capable places to get cured.

Most of the times, wrong predictions happen not because of the doctors don't have sufficient knowledge to handle the case but due to the fact that they don't want to predict for the right disease.

So, a definitive question occurs, "Why will the doctors do such thing?"

The answer is due to sheer greed for money. For example, suppose a patient has been affected with a disease that doesn't require enough tests and expensive medicines. But, unless prescribed the patient with expensive medicines and encourage the patient to do some expensive tests, the doctor will not get the big commission amount that if prescribe will be at the doctor's desk in no time at all.

This is purely a case of nursing home abuse and medical malpractice. Several patients from all over this entire so called beautiful world fall victim under this dangerous medical malpractice services offered by the medical bodies.

However, the time has come to rise up from your seat and join hands to protest against these ill deeds shown by the medical bodies and practitioners.

The most obvious thing you can do to show these evil people that you are ready to protest is to file a medical malpractice lawsuit against this medical bodies or nursing home units.

But you are required to proceed through the proper steps while filing the lawsuit against medical bodies that are quite influential or may have a lot of added knowledge of handling and facing these cases with ease.

So, you need to consult some professional as well highly experienced medical malpractice attorneys about the proceedings and steps required to handle the case. The best option is to appoint one such experienced attorney for handling your case of injustice.

These medical malpractice attorneys know the proper steps that are highly required to move through the proceedings after filing the lawsuit against the medical bodies and will try their level best to bring back the justice, which you truly deserve, before you.

Quite often, when a loved one is no longer able to care for themselves, the only viable option available to the family is to place them in a nursing home. However, once the transition has been made to a nursing facility, how do you know if your loved one is being properly cared for? What do you do if you suspect your loved one is suffering from abuse or neglect at the hands of the doctors, nurses or other staff members at the nursing home? As a family member it is important to know some common signs of abuse and neglect that may occur in a nursing home.

Bedsores - According to the Mayo Clinic "...bedsores are injuries to skin and underlying tissue that result from prolonged pressure on the skin." Bedsores are most often associated with patients who are confined to a bed, but they can also develop on the heels, ankles, hips or buttocks of people who have restricted mobility, such as patients confined to a wheelchair. Bedsores can be avoided by frequently changing the position of patients that have restricted mobility to avoid constant pressure on areas of their body which comes from not being able to move themselves. If your loved one is suffering from bedsores it could be a sign of neglect.

Broken Bones - Elderly people can be more susceptible to broken bones and fractures due to diminished bone density, but these types of injuries can be caused by abuse or neglect as well. If a nursing home resident is not being properly monitored or cared for and falls or experiences some type of traumatic injury which results in broken or fractured bones, this may constitute neglect. If a broken bone is directly caused by an action of an employee of the home, it is most likely abuse. It is important that you contact the proper authorities immediately if you suspect abuse or neglect.

Malnutrition - Malnutrition can be caused by an illness that the patient or resident of a nursing home suffers from, but if no such illness has been previously diagnosed and documented and malnutrition is evident it could be due to neglect or abuse by the nursing home staff. The person suffering from malnutrition may be experiencing intentional refusal by the nursing home or staff to the proper amount or quality of food they require on a daily basis. It may also be a case that they are being intentionally starved in order to "punish" them, or some other form of extremely inappropriate and dangerous behavioral abuse committed by the staff. If you believe that your loved one is suffering from malnutrition you should consult with a doctor outside of the nursing home in order to receive an independent appraisal and diagnosis of potential malnutrition. If the doctor feels that the patient is not receiving the correct nutritional support they require and malnutrition is evident, contact the authorities immediately, and then contact an attorney as well.

Making the life-altering decision to place a loved one in a nursing home can be a phenomenally difficult and emotional task. You shouldn't have to worry about their safety and well-being once they have been entrusted to the care of a nursing facility. Be watchful for signs of abuse and neglect, and if possible, visit your loved one often. Show-up on different days at different times so you can observe and get an idea as to what kind of treatment and support they are receiving during different days and times of the week. If you observe any of these signs of nursing home neglect or abuse in a loved one who it is important that you contact the staff and administration of the facility immediately. If you do not receive the answers or attention you feel are required then notify the proper city, county and health authorities, and immediately contact an attorney that can provide the best assistance in legal support and representation for your loved one during their time of need.

If God isn't really God, who is God? Well, IMHO, God isn't God, since God is a flesh-and-blood extraterrestrial (ET)!

There are two variations to that possibility.

Here's one of those variations. What if God were in reality a very 'flesh-and-blood' extraterrestrial computer programmer, a computer programmer who has written a software package called, say "Planet Earth"? Maybe it's a computer or interactive video game - maybe a homework assignment for a smart extraterrestrial student.

Anyway, computer software easily explains all the Biblical miracles (virgin births; the resurrection, etc.); or anomalies (like where did all the rain come from vis-?-vis the Biblical Flood, and where did all that water eventually go; how did Jonah survive inside a large fish, etc.) or inconsistencies (like Cain's wife; the discrepancies between Biblical time and geological time). Regarding the Biblical flood, no humans actually died; no animals suffered and drowned, and so on, because the humans and animals were never real to start with, just as you and I aren't real, just part of - for want of a better analogy - a computer game simulation.

Let's suppose, for argument's sake that in the real physical Universe, there exists some tens of thousands of extraterrestrial civilizations which have evolved technology our equal or better (even more advanced). The odds are high that most would have invented computers - hardware and software. Any one civilization, such as our own, have (to date) produced multi-thousands of computer programs, many of which simulate life forms - think of the hundreds, indeed thousands of computer/video games. No doubt these programs will grow, over time, ever more complex and lifelike.

If one advanced civilization produces multi-thousands of individual computer programs that simulate an actual, or imagined, reality, what are the odds that we aren't one of those thousands vis-?-vis being that advanced civilization that actually exists? How could you know if you were real, or imaginary? I maintain there's probably no obvious way of you knowing.

Even if there's only a relatively few actual extraterrestrial civilizations, but untold number of created false realities - what odds we are one of the real ones and not one of the imaginary/simulated many?

Is the idea really so way out in left field that there's not a snowball's chance in hell that it could be right? We have to look to advances in our own terrestrial computing power to determine that. Computer generated simulations are already realistic enough that they are used to train astronauts, pilots and MDs and other humans in professional activities where mistakes in training, if done in real situations, could be disastrous. Our cinema industry has already produced computer generated virtual reality films, bypassing real actors and real scenery. It's entirely possible (legal issues aside) to bring back in a sense dead actors to star again in new productions. We've all been awed by computer generated special effects in films that are so realistic that if you didn't actually know better, you'd swear were real.

Walk into any DVD store and you'll find thousands of video (computer) games and/or simulations that you can run on your PC. Most have 'humans' in various role-playing guises that are software generated and which you interact with. The reality factor is increasing by leaps and bounds. At what point will the software become complex enough that these simulated 'beings' are advanced enough to have self awareness? What happens when the software programming these virtual 'humans' becomes equal to the software (brains) that program us? What happens when the computer software complexity exceeds that of the human brain? Is this far-fetched? Methinks not. Now just replace our virtual 'humans' with ourselves, and maybe, just maybe, we're the virtual reality in somebody (something) else's actual reality.

If we, Planet Earth, and our observable universe are nothing but a simulation, that can explain (or at least rationally account for) any and all anomalies (miracles?) that you care to bring up. Software (be it of the wet-ware [brains] or of the computer variety) can create any sort of simulated reality - it doesn't even have to be logical or explainable. Here are just a few Biblical examples off the top of my head.

Biblical One: Explain the parting of the Red Sea in the Bible! It's easy to do in the movies, on a computer, or in your head.

Biblical Two: Then there's this Biblical bit about Joshua commanding the sun to stand still (at least that's the way I recall it). That's either a tall tale or a myth or the result of a simulation. Whatever, it can't be a physical reality.

Biblical Three: In the Bible we have this tale of the multiplying of loaves and fishes out of virtually nothing. Again, you can imagine it, but that's about it. Likewise with any sort of miracle it's easy to visualize the event, but infinitely harder to explain it. But, as in the case of loaves and fishes, it's easy to write a software package that can do this multiplication feat as a simulation exercise.

Biblical Four: Heaven and Hell can be created as easily as any other sort of place, complete with either fluffy white clouds and pearly white gates; harps and haloes, or devils and pitchforks; fire and brimstone!

Biblical Five: If someone (or something) is calling the simulation shots, you could obviously and easily be resurrected or reincarnated or just allowed to cease to be (that is, deleted from the program).

From the examples above, I conclude that it almost seems as if someone (something) is ultimately responsible for aspects of the Biblical part of the Universe, but he / she / it / they didn't quite think things through sufficiently. Methinks an all knowing, all powerful supernatural God type being wouldn't have stuffed things up. If the Bible isn't a stuffed up piece of literary work, I don't know what is because it was either authored by flawed human beings and thus has nothing to do with the infallible word of God, or it was created stuffed up it's because the creator was a flawed flesh-and-blood extraterrestrial entity, and hardly an all-knowing and all-powerful God. Our flawed creator created a simulated Universe, including all the Biblical baggage we have to try to reconcile with a perfect creator God (who, in my version, doesn't exist).

Could there be an afterlife without a God? I suggest that if there is an afterlife, there has to be a natural as opposed to a supernatural mechanism, and that we'd be hard pressed to come up with one. While I can't think of a completely natural explanation to account for any plausible transition from life to afterlife, I can think of a non-supernatural one, albeit it's not totally natural. Just as it's within the realm of possibility that we exist as software in a computer program called "Planet Earth", so too might there be another computer program with associated software called "The Spirit World" or "The Abode of the Afterlife". When you reach your termination as a simulated living being in "Planet Earth", you get resurrected in "The Spirit World". Of course in that sense there's still a god, but a 'god' who just happens to be an extraterrestrial computer programmer, who could be flesh and blood, or maybe an artificial intelligence in its own right. Either way, it's not 100% natural, but it's certainly not supernatural. Of course for all I know there maybe other software programs with names such as "Hell" and "Heaven" or "Valhalla" or maybe dozens, hundreds even thousands of others we've never even conceived or heard of. I mean the virtual beings in one of our terrestrial computer or video games wouldn't be aware that there was thousands of other computer or video games in existence with dozens more being produced and brought out each and every month.

It all makes a sort of sense albeit in a weird or strange sort of sci-fi way. I mean, to paraphrase a rather famous observation, "the universe is not only stranger than we imagine, it's stranger than we can imagine". If there's anyone who can give a definitive proof that we're not a creation of someone's (something's) virtual reality (computer simulation) then I'd like to hear it so I can cross the scenario off my list of things to have to worry about!

That specific aside, if there is any historical evidence for a god, gods or The God, then that evidence could just as easily be equally interpreted as evidence for the existence of extraterrestrial intelligence(s), whose purpose(s) or objective(s) may not be all that benign.

So my second and more likely possible answers to 'if God isn't God, then who is God?' are summed up by the well known phrase 'ancient astronauts'. God is, or was, an extraterrestrial, but not in this case the creator of a simulated universe. Rather, a being within a really real universe. Recall (the late) Arthur C. Clarke's third law, "any sufficiently advance technology is indistinguishable from magic", or in this context, an advanced extraterrestrial technology and alien being welding same is indistinguishable from the supernatural or a supernatural God.

If the above argument is valid, then I conclude that it's easy to explore the nooks and crannies of our galaxy, and seeing that we have no place to run and hide, that then we indeed have been discovered by extraterrestrials. Since one or more extraterrestrial technological civilizations have already done their boldly going exploring thing, it stands to reason that at various times in our geological and historical past we would have received visitors from the stars. If one or more such occurrences happened in our historical past, there might be some suggestive evidence of same; and thus the concept of the 'ancient astronaut' has come to pass.

Erich Von Daniken, including those of a similar point of view who came before and after him, collectively had the germ of a good idea, but he, and they, IMHO got rather carried away with the concept and started seeing ancient extraterrestrial astronauts behind every pyramid and megalith in existence. Now I don't believe for a moment that aliens, or humans assisted by aliens, built the pyramids or the statues at Easter Island or any other type of archaeological monument. Evidence suggestive of ancient astronauts will probably best be found in myths and legends, including the myths and legends central to our major religions, perhaps in advanced human knowledge of scientific concepts out of sync with that particular culture so hosting that knowledge, or in art works, or other archaeological works that are suggestive of an awareness of sky beings.

Firstly, nearly all cultures have stories and pictograms about or of sky beings, including the Australian aboriginals and American Indians. Myths and legends surrounding, say, the Greek / Roman / Norse gods can be interpreted in an ancient astronaut context (ditto for other religious beings or gods), or perhaps the Biblical 'Wheel of Ezekiel' is suggestive. While the etchings on the Plain of Nazca were certainly not runways, for flying saucers, they can easily be interpreted as mammoth human constructions designed to be viewed by sky beings. Why go to the trouble if sky beings weren't really around to appreciate your efforts?

Then there's a whole pot-full of mythological creatures - the Centaur, unicorns, the Sphinx, the Griffin, Pegasus, the Minotaur, mermaids, dragons, etc. which might be non-humanoid extraterrestrial life forms. Or, more realistically, perhaps in light of the UFO abduction and Roswell greys, are the myths and legends shared by many cultures dealing with elves, dwarfs, gnomes, the fairy-folk, the wee-people, and other smallish beings that aren't quite human. It strikes me as more logical that these 'wee folk' actually exist, and that's why all the references to, and belief in, them, exist. That is, they are really real vis-?-vis references to, and belief in them, because there is some psychological, sociological or cultural necessity to invent imaginary beings, calling it mythology (as opposed to literary fiction), or perhaps calling it religion.

In conclusion, the 'ancient astronaut' field is a subject ripe for detailed academic study, and the concept of the 'ancient astronaut' shouldn't be dismissed by scholars are readily as it has been. Unfortunately, it's unlikely any academic would put his or her career on the line by pursuing such a controversial, 'pseudo-scientific, topic because of the 'giggle' factor - Pity that.