Today’s featured senior living facility is Pinebrook Rehabilitation and Nursing Center in Venice, FL. Pinebrook is a 120-bed facility that offers a wide range of post-acute care, short-term rehabilitation, long-term care, and other specialty medical services. They also have a special Alzheimer’s care unit called the Avalon Wing, and they provide hospice-related services (in partnership with a licensed hospice organization) and respite-care services (for elderly people whose primary, at-home caregiver is temporarily unavailable).

Pinebrook has been part of the Venice, Florida, community for more than 17 years. Last year the facility received the Excellence in Action Award from the Florida Health Care Association, in recognition of outstanding customer service.
One of the facility’s unique features is an outdoor therapy garden. This functional therapy garden provides real-life activities where elderly residents can regain balance, strength, mobility-and confidence. For example, instead of using parallel bars indoors, patients can cross a bridge with parallel railings that spans a man-made koi pond.

Other therapeutic areas include:

• A beach-like area to practice walking in sand
• A gravel walkway similar to many home driveways
• An uneven pavement area

Pinebrook also offers:

• On-site beauty/barber shop
• Common room
• Several dining rooms
• Family lounge
• Well-equipped therapy gym
• Koi pond
• Picnic areas
• Assistance with scheduling transportation to medical appointments and nearby shops

To learn more about Pinebrook Rehabilitation and Nursing Center, visit www.pinebrookrnc.com. For a searchable database of senior living facilities in Florida, visit Florida Senior Living Advisor.

The operators of three separate assisted living facilities in Florida have been arrested, all on charges of operating without licenses. One of the arrests was in Volusia County, the others in Duval County.

In Volusia, officers from the state’s Medicaid Fraud Control Unit arrested Marjorie Nelson, owner and operator of Helping Hands Manor I and II in Edgewater. According to the Attorney General’s office, Nelson told investigators she had not licensed the second location because upgrading the septic system and fire suppression systems would cost too much. Those upgrades were necessary to qualify for a license. Nelson is charged with operating an unlicensed assisted living facility, a third-degree felony. If convicted, she faces up to five years in prison and a $5,000 fine.

In Duval County, officers arrested Tommy Teague and Roberto Gallegos on charges of operating an unlicensed facility at 2198 Mossbrook Court in Jacksonville. Teague and Gallegos face third-degree felony charges and could each face up to five years in prison if convicted.

At the third facility, Medicaid fraud investigators determined through a routine spot-check that Torina Brooks had exceeded the capacity of her licensed facility, Pauline’s House in Jacksonville. Brooks placed the extra clients in an unlicensed facility across the street and requested Medicaid reimbursement for their care. She faces one count of operating and/or maintaining an assisted living facility without a license, one count of Medicaid fraud and one count of grand theft, all third-degree felonies, and could face up to 15 years if convicted of all charges.

To legally and properly operate an assisted living facility in the state of Florida, there are various administrative and operational requirements which must be met. These include licensing procedures, staffing requirements, compliance with county health and local fire authority regulations and the safe management of medication by trained staff personnel.

For a searchable database of licensed assisted living facilities throughout Florida, visit Florida Senior Living Advisor. Licensing status can change, so be sure to ask for proof of licensure when visiting a facility. For more information on the Florida’s licensing process for senior living facilities, visit the Florida Agency for Health Care Administration (AHCA).

There is a crisis looming in our ability to care for the elderly in this country. I’m not talking about the healthcare debate or the solvency of Medicare. I’m talking about a growing shortfall in the number of doctors trained to care for the special health problems of the elderly. These doctors are known as geriatricians. And with our nation’s senior population due to explode in the next few decades thanks to the  aging of the Baby Boomer generation, this could present a serious problem.

According to the American Geriatrics Society, there are currently 7,590 certified geriatricians in the US — one geriatrician for every 2,500 Americans 75 or older. Due to the projected increase in the number of older Americans, this ratio is expected to drop to one geriatrician for every 4,254 older Americans in 2030.

One reason geriatrics does not appeal to medical students: money. According to the AGS, the median salary for a geriatrician in private practice in 2006 was $161,888. This was $2,133 less than the average family physician’s salary, and $15,171 less than the average general internist’s. Geriatricians train at least one year longer than their primary care colleagues, and yet they are compensated at a lower level. In many parts of the U.S., Medicare payment rates for physicians are lower than commercial insurance rates. Medicare reimbursement is the major source of income for most geriatricians and, as a result, community-based geriatricians have lower incomes than most other physician specialists.

The University of New England has created a unique program to give its medical students first-hand experience in a nursing home. UNE’s college of Osteopathic Medicine operates the “Learning by Living” project, which places a medical student in a nursing home to live the life of an elder resident for two weeks, 24/7. The goal is to equip the students to become more effective physicians, and also to offer a fresh perspective to nursing home administrators.

I came across an interesting article that I want to share with you. It comes from ww.medicalnewstoday.com, and I am using parts of it with the site’s permission. The article is titled  “Baby Boomers Face Down Aging: 10 Most Common Medical Challenges.” It offers a snapshot of the ten challenges that baby boomers will face in the coming years as more and more of them hit 65. And since the US Census Bureau estimates that nearly a quarter of the US population will be 65 or older by 2030 (today that group is around 13% of total), this means these are issues that will balloon in scope and impact in coming years.

Of course, these are also issues that today’s elderly population is dealing with. So whether you are caring for an elderly loved one right now, or looking toward your future as a senior citizen, I think this list provides some valuable information to keep in mind. It comes to use from researchers and clinicians in the Division of Geriatric and Palliative Medicine at The University of Texas Medical School at Houston.

10 Most Common Medical Challenges Facing Baby Boomers

1. Functional decline: According to the U.S. Department of Agriculture, the body loses one percent of muscle mass a year beginning at age 45, which can result in sarcopenia as skeletal muscle is eventually replaced with fat and the body becomes weaker. Some research has linked protein deficiency with sarcopenia. For every week spent in the hospital, it takes an aging body a month to recover muscle strength with daily rehabilitation, says geriatrician Liliana Andrade, M.D., assistant professor of internal medicine at the UT Medical School at Houston. Exercise, including resistance and strength training, is absolutely essential for retaining muscle mass and strength. “For balance, tai chi is good,” she says. “We also encourage patients to rent ’sit and be fit’ videos that use hand and leg weights.”

2. Depression: Considered as prevalent as the common cold in the elderly, depression can be the result of major life changes, including retirement, losing loved ones and loss of mobility and independence. It can show up differently in older people, says geriatrician Nasiya Ahmed, M.D., assistant professor of internal medicine at the UT Medical School at Houston. “There’s not as much of a tendency toward tearfulness or feelings of hopelessness,” she says. “Instead they have vague somatic complaints, increased pain, not sleeping or eating well or general apathy.”

3. Disease: Chronic diseases associated with the aging process, including high blood pressure, stroke, cardiovascular disease, osteoporosis, chronic obstructive pulmonary disease, hypothyroidism, constipation, incontinence and arthritis, can take their toll. Preventive measures taken now such as quitting smoking, eating healthy food and exercising are all important steps toward a better quality of life. “Even quitting smoking at age 60 is better than not quitting at all,” Andrade says.

4. Polypharmacy: A term geriatricians are using for the number of prescription and over-the-counter medications that elderly people are taking in alarming numbers is polypharmacy. “People go to five different doctors and none of the others know what is going on,” Ahmed says. In some cases, seniors who wind up in the hospital may be prescribed a different medication for an existing condition such as high blood pressure because the hospital doesn’t stock the particular one they’ve been taking in the past. The patient returns home with a new prescription from the hospital physician and continues taking the other medication as well, which can be deadly. “I’ve had patients come in who are taking 20 different medications,” Andrade says. “A lot of them also take vitamins and herbal supplements that they don’t need and that can interfere with medications.” The solution, they say, is to have a written record of all prescriptions, supplements and vitamins that they can bring to their appointments and have a family practitioner or geriatrician who can be the lead physician in managing their care.

5. Falls: Low blood pressure, which can be a result of poorly managed hypertension or dehydration, can lead to dizziness. That dizziness, combined with a decreased ability of the vascular system to compensate for changes in position such as standing up, is the largest cause of falls, they say. “So many patients have told me that they take blood pressure medication when they feel like it’s high instead of taking it as it is prescribed,” Ahmed says. “I ask them how they know it’s high and they give vague signs such as their nose tingles or their tremor worsening.” Taking medications for sleep can also be dangerous. “Some take Benadryl to help them sleep and as people get older, that’s not such a good thing because it causes confusion and they can fall because they’re sleepy,” Andrade says.

6. Abuse and neglect: These two problems, including self-neglect, will continue to afflict the elderly, says Carmel B. Dyer, M.D., professor and director of the geriatric and palliative medicine division at the UT Medical School at Houston and co-author of the book, “Elder Abuse Detection and Intervention.”

7. Financial exploitation: Vulnerable elderly people can easily become victims of family members or caregivers. “We see cases where grown children have moved back in with them and are depending on them financially. They use their resources, borrow the car, rely on them to baby sit, and it upsets the senior’s ability to function,” Ahmed says. “I had one patient in her early 80s whose leg had just been amputated and she was still babysitting her 11- and 12-year-old grandchildren, who were taunting her.”

8. Dementia: Alzheimer’s disease is the most common form of dementia, a gradual decline in a person’s mental functioning, and is the fifth leading cause of death for Americans over age 65, according to the National Center for Health Statistics. The Alzheimer’s Association reports that Alzheimer’s disease and dementia triple healthcare costs for people over 65. But education about dementia and possible treatments including medications is lacking, Ahmed and Andrade say. “There are now more medications that are helpful. They can’t cure it, but they can help,” Andrade says. “Unfortunately, a lot of people are in denial. I had a 78-year-old patient who I knew was suffering from dementia because of the way he was managing his medications and health. But his son got upset when I started talking about it and they left the room.”

9. Caregiver burnout: As baby boomers age, many will also be taking care of their own aging parents. That brings caregiver burden, which can lead to a higher risk for depression and other stress-related illnesses. Ahmed says caregivers should solicit health resources, such as daycares for seniors, to help them shoulder the stress. They should take advantage of support groups and ask social workers regularly about available community resources. Special units for acute care for the elderly (ACE units), can help make hospitalizations less stressful for the patient and family.

10. Death and dying: Baby boomers will have to decide how they want to live out the end of their lives and how they want to die. Cultural and religious beliefs will impact these decisions and physicians will need to be sensitive to that, Ahmed says. As patients age, the physician begins to play a larger role in a patient’s life and strong physician-patient relationships will be important in determining a patient’s wishes. People should make those wishes known to family members and caregivers and put them in writing.

Source: www.medicalnewstoday.com

An Orlando-area senior living facility is awaiting test results to determine the source of a virus that has sickened more than a dozen elderly residents. According to Dain Weister of the Orange County Health Department, last week 16 elderly residents at Emeritus at Crossing Pointe developed gastrointestinal problems such as diarrhea, vomiting and nausea. With today’s heightened awareness of swine flu, that was the first concern, but Weister told me they have  ruled that out. He said they have  also determined it was not a food-borne illness. He said they suspect it could be norovirus, sometimes known as stomach flu.

Emeritus at Crossing Pointe offers independent living, assisted living and Alzheimer’s care to 179 residents. This past weekend, the facility was closed to visitors in an effort to stop the spread of the illness. As of today, just the second floor memory care unit is still closed since that is where the outbreak occurred. A few of the sick residents had to be hospitalized but all are now back at Emeritus, according to Weister.

Weister said norovirus outbreaks are not unusual in nursing homes. According to the Centers for Disease Control, norovirus is highly contagious. The symptoms usually include nausea, vomiting, diarrhea, and some stomach cramping. Sometimes people additionally have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly, and the infected person may feel very sick. In most people the symptoms lasting for about 1 or 2 days. One of the most common complications of norovirus among the elderly is dehydration.

Many senior living facilities are run by large regional and national corporations. Those that are locally owned are usually very small, housing maybe half a dozen residents. Courtyard  Gardens in Jupiter, FL is an exception and it is this week’s Friday’s Featured Facility on the Florida Senior Living Advisor blog. Courtyard Gardens is an assisted living facility with just more than 100 residents. It opened 10 years ago and is owned by a local resident, Dr. George Peck, and his daughter.

Courtyard Gardens Marketing Director Donna Phillips started working at the facility after her mother moved in nine years ago. She told me she was raving about the care her mother was receiving to anyone who would listen, and that’s when management approached her about becoming the marketing director. “I know what people are going through because  I’ve been there,” she said. When asked what sets Courtyard Gardens apart, Phillips says it is the facility’s caring and qualified staff.

“We have 85 staff for 111 residents. And we put money into their continuing education,” she explained. “Everyone has Alzheimer’s training, even the front desk receptionist. And everyone has first aid training.” Phillips says every employees understands that the residents come first, and their safety and happiness are the top priorities.

Phillips says another reason they are always at 100% occupancy is the great food. “Our chef is from the Ritz-Carlton. Everything is made from scratch, and we always have fresh fruit and vegetables,” she said. Rates at Courtyard Gardens range  from $3135 for a studio to $4140 for a one-bedroom apartment. In addition, there are “levels of care” that can be added on if a resident needs help showering, taking medication, etc. These levels add about $400 to the monthly fee. In the Alzheimer’s unit, costs range from $3700 for a shared unit to $4500 for a single.

To learn more about Courtyard Gardens, visit the facility’s website at www.courtyardgardens.com.

GPS-fitted shoe by Aetrex & GTX

We hear about it far too often- an elderly person with Alzheimer’s or dementia who is missing. In the past few days, I’ve come across these news stories online:

• Virginia State Police are searching for a woman with early stage Alzheimer’s who wandered away from her Eastern Shore home overnight…
• Police are looking for a Georgia woman with Alzheimer’s disease who went missing Saturday afternoon in New Orleans…
• Authorities asked for the public’s help in locating an elderly Millard County man with Alzheimer’s Disease…
• Search is on for woman, 87, with mild dementia…

It’s a frightening situation for caregivers, and an unsafe and sometimes tragic one for the patient. But recently I heard about a new device that could truly be a lifesaver: a shoe outfitted with a GPS tracking system that can locate the wearer instantly.

According to the Alzheimer’s Association, as many as 5.3 million people in the United States are living with Alzheimer’s. Patients of Alzheimer’s, the leading cause of dementia, can easily become confused or disoriented, and it’s common for them to wander from their home or senior living facility and not be able to find their way back. The tracking device in this shoe is intended to be totally unobtrusive. In addition to providing real-time information on the elderly person’s location, caregivers will also have the option to subscribe to a GTX service that automatically alerts them when the wearer of the shoe leaves a designated boundary.

Of course one of the stumbling blocks here is whether your loved one is willing to wear such shoes. There are all sorts of issues of privacy and consent. No one is more stubborn than my elderly father. He still lives independently in a continuing care retirement community, but in recent years  I have noticed that he is more accepting of his limitations and maybe even a little scared at times. As I’ve written before, he suffered a terrible fall in his apartment last September and nearly 32 hours passed before he was found. He is now fully recovered, but that tragedy scared him into agreeing to wear an “alert” necklace that he can use to signal if he is ever incapacitated in the future. I’d like to think that if he started to develop dementia, he might be willing to wear a shoe such as this, if not out of concern for his own safety than maybe out of concern for my peace of mind.

Of course, my husband reads this and his first thought is, “Can’t we get those shoes for our daughters?” That’s a topic for a different blog!

The shoe is a collaboration between GTX Corp., a firm that specializes in miniaturized GPS tracking devices, and footwear company Aetrex. Details are still being worked out, but GTX expects the shoe to retail for around $200 to $300 and be available some time next year.

For this week’s Friday’s Featured Facility- a community that may represent a trend in senior living. Oak Hammock at the University of Florida in Gainesville is the only university-based retirement community in Florida and one of only a handful across the country. But these types of senior living facilities are attracting attention and popularity among boomers who appreciate the vibrant educational, cultural and social offerings that a university setting can offer.

Oak Hammock’s 136-acre facility is a continuing care retirement community (CCRC), meaning it offers a range of options – everything from independent living to assisted living to memory care and skilled nursing. For a one-time entrance fee, ranging from  $147,500-over $500,000 – Oak Hammock residents are guaranteed long-term care at a significantly reduced rate. There are also monthly fees ranging from $1800-5000 to cover everything from utilities to social activities and some meals.
What makes Oak Hammock unique is its integration with the University of Florida. Star Bradbury, Director of Life Planning at Oak Hammock, told me that the community would not exist without the University. Oak Hammock’s board is appointment by UF’s president, and the school’s deans and staff provide input for the community’s activities. Among the benefits listed on Oak Hammock’s website are:

• Because our 22,000-sq.-ft. Fitness Center is affiliated with UF’s College of Health and Human Performance, attention has been paid to the smallest detail – from installing the right equipment to calibrating the ideal temperature for the swimming pools. 
• The College of Dentistry staffs an on-site, full-service dental hygienist suite.
• The College of Veterinary Medicine operates a Veterinary Clinic at Oak Hammock, providing routine wellness care. Pet sitting is also offered.
• The College of Fine Arts provides performance venues and schedules on-site recitals.
• The College of Medicine provides a Mini-Medical School series.
• The College of Pharmacy provides weekly consulting services with members
• Liberal Arts and Sciences presents educational programs in a wide range of disciplines.
• Oak Hammock members serve as mentors, lecturers and volunteers in the University’s many academic programs. 
• Because Oak Hammock is directly affiliated with the University of Florida, members have campus privileges similar to those of University faculty – with access to sports, performing arts events, library and research facilities, and more.

Oak Hammock is home to approximately 400 people. Most live in independent living apartments or freestanding homes. The facility also has a capacity for 42 people in its assisted living unit, 42 in skilled nursing and 24 in memory care. Oak Hammock currently has a waiting list, but if you are interested, you can secure a spot on that list for a fully-refundable $1500 deposit.

To learn more about Oak Hammock at the University of Florida, visit www.oakhammock.org.

The latest research on dementia gives new meaning to the phrase “food for thought.” A study released yesterday indicates that individuals with even borderline to moderately high cholesterol levels in their 40s have a much greater chance of developing dementia later in life.

Researchers tracked nearly 10,000 people for four decades, starting when the participants were between 40 and 45. After controlling for weight, hypertension and diabetes, researchers discovered a significant link between borderline-high cholesterol and dementia, according to the study.Participants who had high cholesterol (240 or more) had a 66 percent greater risk of developing Alzheimer’s disease later in life. People with borderline-high cholesterol (200-239) had a 25 percent spike in risk.

Although previous studies have linked heart and brain health, researchers said this study is the first to examine the association between borderline cholesterol levels and dementia. And although dementia does not typically strike until later in life, “it’s a disease of a lifetime,” said Rachel Whitmer, Ph.D., a research scientist at Kaiser Permanente and senior author of the study. “We need to think about it like we do for cardiovascular disease.”

Experts agree that a three-pronged approach of daily exercise, stress reduction and nutrition can naturally lower levels. A diet rich in olive oil, nuts, whole grains, fiber, fresh fruit, vegetables and a limited amount of red meat is best, according to the Mayo Clinic.

“Our study shows that even moderately high cholesterol levels in your 40s puts people at greater risk for Alzheimer’s disease and vascular dementia decades later,” said Whitmer. “Considering that nearly 100 million Americans have either high or borderline cholesterol levels, this is a disturbing finding. The good news here is that what is good for the heart is also good for the mind, and this is an early risk factor for dementia that can be modified and managed by lowering cholesterol through healthy lifestyle changes.”

The study appears in the journal Dementia & Geriatric Cognitive Disorders.

I am trying to vary the topics for my Florida Senior Living Advisor blog, from the lighthearted to the more serious, but all with a focus on topics of interest or importance to senior citizens, their caregivers and family members. One topic I will always address is any instance of elder abuse that I hear about at a Florida senior living facility. And unfortunately, there seems to be plenty of material on this topic.

In the less than three months since I launched Florida Senior Living Advisor, this is now the fourth incidence of abuse that I am reporting. In this most recent case, a Broward County woman faces charges of abuse of an elderly person after she allegedly attacked a 65-year-old patient at the Manor Pines Nursing and Rehabilitation Center in Fort Lauderdale. To make matters worse, the patient suffers from Parkinson’s disease.

Eronie Deverlus, 50, was arrested a few days ago by law enforcement officers with the Attorney General’s Medicaid Fraud Control Unit. According to Sandi Copes, a spokeswoman for Florida Attorney General Bill McCollum, Deverlus was a nursing assistant at Manor Pines and While working at the center, she allegedly struck the female patient in the face after becoming angry with the woman.

Deverlus, who was fired shortly after the incident, is charged with one count of abuse of an elderly person, a third-degree felony. If convicted, she faces up to five years in prison and a $5,000 fine.