APRIL | MAY | JUNE • 2011 MEDICAREtalk Important Information for People on Medicare from the Arkansas Foundation for Medical Care Inside Hiring a caregiver: What you should know Having trouble understanding your long-term care options? Colorectal cancer screenings: Everyone over 50 needs to have them “Ask Me 3” campaign encourages patients to get informed can help! The Medicare Quality Improvement Organization for Arkansas Continued from the front page “We know that navigating the maze of long-term care programs and services is not easy. Our counselors will help you learn about your options and provide the information you need to make the best decisions.” — Choices in Living website, www.choicesinliving.ar.gov Choices in Living can help you understand long-term care options I n Arkansas, there are different publicly funded programs that provide assistance and support to seniors and people with disabilities. But it can be tough to gather all the details about these programs, compare them and choose one that will work best for your specific needs. The Choices in Living Resource Center can help. The center is a free, reliable source of information and guidance that can help you understand the different long-term care options available to you. Trained counselors can help you make an informed deciChoices in Living home page sion when it’s time to choose long- at www.choicesinliving.ar.gov. term services. Some of the services that information about support in caregiving, energy Choices in Living offers include long-term care assistance, assistive technology and many other options counseling, benefits counseling and access publicly funded programs, such as the Supplemental to publicly funded long-term care programs such as Nutrition Assistance Program (SNAP) and Medicaid. ElderChoices, Alternatives, Independent Choices Choices in Living does not charge for its services, and Living Choices. ElderChoices, for example, is and the center is open to anyone who is interested. a program to help older people get the support they Seniors, individuals with disabilities, families, need to stay healthy and live independently at caregivers and service providers are especially likely to home. This is just one of the many programs that find the center’s resources helpful. Choices in Living can inform you about. There are You can call the Choices in Living Resource Center usually eligibility requirements and other details toll-free at 1-866-801-3435, Monday – Friday, 8 a.m. about programs that Choices in Living can help to 4:30 p.m. You can also find more information on the you understand. The center can also give you more center’s website at www.choicesinliving.ar.gov. Hiring a caregiver: What I you should know n years past, generations of family members lived together and usually cared for any sick or elderly loved ones. But today, most adults do not live with their aging relatives, so it’s becoming more and more common to hire a home-based caregiver for your aging loved one. Read on for helpful information from the Schmieding Center for Senior Health and Education on how to best do this. Where to start Get started by making a list of needs and categorizing them into personal care, household chores, health care and emotional care. Be sure to consider the values and preferences of the person who will be receiving care, such as background, culture, value systems and language. Keep in mind some tasks require minimal skill and others may need special training or licensure. Generally, the person requiring assistance in the home will benefit most from a caregiver who offers both physical skills and behavioral training that match the needs of the care recipient. Types of caregivers Home care workers may use many different titles. Here are some com- Home care assistant: This term is used by the Schmieding Center to designate graduates who have completed 100 hours of formal training in home caregiving, similar to the previous designation. Certified nursing aid: In Arkansas, this term is used for people who have successfully completed at least 90 hours of training as a nursing assistant in an approved training program, and who have successfully passed a state certification exam. CNAs must also have a minimum of 15 hours of training in the care of a person with dementia. Hiring process monly used titles and what they usually mean: Companion: No formal training required. Services usually include supportive care such as escorting, safety supervision or assistance with common household duties. Elder pal: This is a trademark designation used by the Schmieding Center which requires 25 hours of formal training in elder caregiving. This individual has received both classroom and clinical training from a licensed nurse and can provide companionship, safety and support for individuals requiring minimal assistance with activities of daily living in the home. Personal care aide: Requires a minimum of 40 hours training from a licensed nurse in providing personal care skills (usually bathing and hygiene). This person generally works for the state Medicaid program providing personal care, but may also work for a private home care agency. There is no state certification or registry for personal care aides in the state of Arkansas. Personal care assistant: This term is used in many settings, but the Schmieding Center uses it for graduates who have completed 50 hours of formal training in home caregiving. This training includes classroom and clinical training provided by a registered nurse. A personal care assistant is qualified to provide care for someone requiring minimal to moderate assistance with activities of daily living and personal care in the home. There are two options when hiring home care workers: hiring the person yourself or working with a company. If you choose to hire a home care worker on your own, the individual works directly for you and you are the employer of record. If you work though a private company, the company is the employer of record. Hiring your own home care worker enables you to interview and hire the person you think is best suited to care for your family member. It is usually less expensive than going through an agency; however, hiring your own worker means you assume responsibility for screening, scheduling, supervising and paying taxes. Also, if the person you hire calls in sick, you are responsible for having a backup plan and finding a replacement. The state of Utah publishes a helpful, easy to understand booklet that explains the steps of hiring, training and managing personal care assistants and is available at: www.ucare. gov/caregiver_guide. Click on Module 11, “Hiring, Training and Managing Personal Assistants.” Additional information on paying taxes is available from the Family Caregiver Alliance and the Internal Revenue Service at: www.irs.gov/businesses/small/ article/0,,id=99921,00.html. The advantage of using an agency is that they usually take care of all the details and paperwork of hiring a home care worker. They will also work with you to find someone who is compatible, but keep in mind, they will generally charge more per hour and they may also have a minimum number of hours a person will work per day or visit. Whether you go through an agency or not, you should always have a job description and a detailed list of what you expect the person to do, and not do, while they are working for you or your family member, and a contract that formalizes the agreement. A care plan that details the needs, strengths and limitations of the care recipient is also helpful. Helpful resources The internet offers a wealth of information about hiring help in your home. Just be sure it is published by reputable sources such as the state or federal government, nonprofit agency or university. Some reputable sites include: nAARP: www.aarp.org nAdministration on Aging: www.aoa.dhhs.gov nAmerican Geriatrics Society: www.americangeriatrics.org nArkansas Direct Service Workers Registry: dhs.arkansas.gov/daas/dswregistry nFamily Caregiving Alliance: www.caregiver.org nNational Family Caregivers Association: www.nfcacares.org nNational Caregivers Library: www.caregiverslibrary.org nNational Institute on Aging: www.nia.nih.gov nNational Quality Caregiving Network: www.nqcn.org nThe Well Spouse Foundation: www.wellspouse.org Colorectal cancer screenings: Everyone over 50 needs to have them A lthough colorectal (colon) cancer is one of the most preventable cancers, it’s also the second leading cause of cancer-related deaths in the U.S. Because it often starts with no symptoms, regular screening is very important — treatment is most successful if it begins in the early stages of the disease. The Centers for Disease Control and Prevention (CDC) recommends that every man and woman aged 50 years and older be screened regularly. It’s estimated that at least 60 percent of deaths from colorectal cancer could be prevented if everyone aged 50 years or older had regular screening tests. Some people who are at high risk for colorectal cancer should begin receiving regular screenings earlier than age 50. People who may be at high risk include those with a family history of colorectal cancer and people who have inflammatory bowel disease. Check with your doctor to find out if you are at high risk for this disease. To learn more about how to reduce your risk for colorectal cancer, visit www.cdc.gov/cancer/ colorectal. You can see personal screening stories (where real patients describe their screening experiences), send a health e-card to remind a loved one to get screened and access a variety of helpful resources. Also, Arkansans on Medicare may always contact AFMC at 1-888-354-9100 or www. afmc.org with questions about which tests Medicare covers. “Ask Me 3” campaign encourages patients to get informed id you know that health literacy has nothing to do with education, income, gender or race? Health literacy is a person’s ability to understand the basic health information and services needed to make appropriate health decisions. The “Ask Me 3” campaign encourages patients to ask their doctors a few simple questions and make sure that they understand the answers. The questions are: n What is my main problem? n What do I need to do? n Why is it important for me to do this? People who understand the answers to these questions tend to have fewer health problems, because they know how to take medication as prescribed or how to prepare for a medical procedure. They may also get well sooner or be able to better manage a chronic health condition. 1000 Fianna Way P.O. Box 180001 Fort Smith, AR 72918-0001 Inside this issue of Your Medicare information source from the Arkansas Foundation for Medical Care Having trouble understanding your long-term care options? Choices in Living can help! Hiring a caregiver: What you should know These days, it’s becoming more and more common to hire a home-based caregiver for your aging loved one. Colorectal cancer screenings Everyone over 50 needs to have them — treatment is most successful if it begins in the early stages of the disease. This material was prepared by the Arkansas Foundation for Medical Care Inc. (AFMC), the Medicare Quality Improvement Organization for Arkansas, under contracts with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, and the Arkansas Department of Human Services, Division of Medical Services. The contents presented do not necessarily reflect CMS and Arkansas DHS policies. The Arkansas Department of Human Services is in compliance with Titles VI and VII of the Civil Rights Act. QB1-MT.NEWS,2-4/11 Learn more about AFMC and find answers to Medicare questions on our website: www.afmc.org Call AFMC on our Medicare helpline at 1-888-354-9100. You can call AFMC if you have: ■Concerns about the quality of care you receive. ■Received a notice of discharge or Medicare noncoverage from a hospital, skilled nursing facility, hospice, home health agency or comprehensive outpatient rehab facility, and you disagree. ■ Questions about your Medicare rights.