When a Person with Alzheimer’s Rummages and Hides Things, from nia.nih.org

August 22, 2017

Someone with Alzheimer’s disease may start rummaging or searching through cabinets, drawers, closets, the refrigerator, and other places where things are stored. He or she also may hide items around the house. This behavior can be annoying or even dangerous for the caregiver or family members. If you get angry, try to remember that this behavior is part of the disease.


In some cases, there might be a logical reason for this behavior. For instance, the person may be looking for something specific, although he or she may not be able to tell you what it is. He or she may be hungry or bored. Try to understand what is causing the behavior so you can fit your response to the cause.


Rummagingwith Safety

You can take steps that allow the person with Alzheimer’s to rummage while protecting your belongings and keeping the person safe. Try these tips:

Lock up dangerous or toxic products, or place them out of the person’s sight and reach.

Remove spoiled food from the refrigerator and cabinets. Someone with Alzheimer’s may look for snacks but lack the judgment or sense of taste to stay away from spoiled foods.

Remove valuable items that could be misplaced or hidden by the person, like important papers, checkbooks, charge cards, jewelry, and keys.

People with Alzheimer’s often hide, lose, or throw away mail. If this is a serious problem, consider getting a post office box. If you have a yard with a fence and a locked gate, place your mailbox outside the gate.


How to Help

You also can create a special place where the person with Alzheimer’s can rummage freely or sort things. This could be a chest of drawers, a bag of objects, or a basket of clothing to fold or unfold.

Give him or her a personal box, chest, or cupboard to store special objects. You may have to remind the person where to find his or her personal storage place.

Keep the person with Alzheimer’s from going into unused rooms. This limits his or her rummaging through and hiding things.

Search the house to learn where the person often hides things. Once you find these places, check them often, out of sight of the person.

Keep all trash cans covered or out of sight. People with Alzheimer’s may not remember the purpose of the container or may rummage through it.

Check trash containers before you empty them, in case something has been hidden there or thrown away by accident.


Remember, this behavior is part of the disease and no one is at fault for it.  Learn how to best manage and cope and you’ll all be happier for it.


For more information about Alzheimer’s and related dementias, call 1-800-438-4380 to reach the National Institute on Aging’s ADEAR Center. (Alzheimer’s Dementias Education And Referral) or go to www.nia.nih.gov/alzheimers


Feel free to contact PA HOME CARE with any questions or for help at home.  We’re here to make your life easier and we’re committed to helping seniors age in place, safely and securely, in the comfort of their own homes.

“With Hearts and Hands, We Care”

call 717-464-2006

email PAHC@PA-HomeCare.com



Holiday Visits and Safety for People with Alzheimer’s

December 27, 2016

From the National Institute on Aging and the NIH:

Over time, people with Alzheimer’s disease become less able to move comfortably and safely around the house. As a caregiver, you can do many things to make the person’s home a safer place. Think prevention—help avoid accidents by addressing possible problems.


Prevent falls and injuries around the house with these tips:

* Simplify the home. Too much furniture can make it hard to move around freely

* Get rid of clutter, such as piles of newspapers and magazines.

* Have a sturdy handrail on stairways.

* Put carpet on stairs, or mark the edges of steps with brightly colored tape so the person can see them more easily.

* Put a gate across the stairs if the person has balance problems.

* Remove small throw rugs. Use rugs with nonskid backing instead.

* Make sure cords to electrical outlets are out of the way or tacked to baseboards.

* Clean up spills right away.


Get practical home safety tips for a person with Alzheimer’s disease from the National Institute on Aging: http://bit.ly/2idfx0q

#Alzheimer’s #caregivers—follow these tips to help prevent falls and injuries around the house: http://bit.ly/2httHLD


Have a happy, and safe, holiday visiting with your loved ones, especially those living with Alzheimer’s.  Cherish these moments.  Best Wishes from your friends and neighbors at PA HOME CARE of Lancaster.  “With Hearts and Hands, We Care“, over the holidays, and always.


Contact us today if we can be of service to you or your loved ones, phone: 717-464-2006, email: PAHC@pa-homecare.com .

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Summertime, and Especially for Seniors, Exercising can be Easier by Ashley Gonzalez

July 14, 2016


Now that it is already July, the summer is definitely in full swing. The weather is warm and sunny, with the occasional thunderstorm, and the sun is shining. This time of year I just cannot wait to get outside! There is so much to do, from walking, hiking, biking, swimming, to relaxing with a good book and a glass of iced tea. This time of year is perhaps our most active time. During the long winter months with short days and inclement weather, it takes a whole lot of motivation and gumption to get this girl out the door or even to the basement to workout. Before we get too gloomy, let’s focus on this beautiful time of year and let’s get moving!

Exercise is so important for people of all ages. It is important for my husband and me to keep our bodies fit with a healthy diet and regular exercise; and its important for you too. Exercise helps us to feel better during the day, it energizes us to keep up with our daily activities (in our case our little girls), and it helps us to sleep better. It’s important for our parents who are wrestling with slower metabolisms and increasingly familiar aches and pains. Exercise helps encourage weight loss, it charges up gains in energy, and can even help to relieve many of the everyday pains that most Americans believe are just part of growing older. My grandfather is living in a Veterans Home in Oklahoma, and he loves his physical therapy. His therapist easily gets his body moving every weekday and encourages him to keep moving, as much as he can. Even my 1½-year-old toddler loves to move and shake. Exercise is truly good for the body, any body, regardless of age or physical limitations.  Let your mantra be “Do what you can, as much as you can!”

Let’s talk about how to best help the older adults in our lives move more. First of all, it is so important for them to stay active, even if the definition of active is different from what you or I might first think of. To start, it’s important to not push too hard and risk injury. It may take a few weeks for your loved one to work up to the point of doing some of the recommended time and/or exercises listed here. Be patient. It is well worth the wait and the process for them to become healthier, happier, and more self-confident. There are four main categories of exercise that we will cover here.  With all of these categories, remember, start small and work your way up by exercising regularly and increasing intensity gradually.

The first two categories I want to talk about are balance and flexibility. These are not usually the first to pop into peoples’ minds when you mention exercise, but they are just as important.

balance seniors

Balance Exercises promoting balance are particularly important for older adults, especially those who spend a significant amount of time sitting or laying down. Even older adults who are not as sedentary can still find they are afraid of falling or have fallen in the past. Balance exercises can help them to become more confident and help to strengthen their bodies. You can practice these exercises everyday and every little bit helps!  Some examples of balance exercises include walking a straight line (use painters tape to create a straight path), use a chair to hold on to while balancing on one leg, high knees (marching exercise), and heel to toe walking. Remember to always use proper equipment to help your loved one while they practice their balance. If they become dizzy or lightheaded, stop immediately and let them sit down to regain their composure before beginning again.

stretch exercise

Flexibility Exercises that will help to decrease and reduce muscle soreness and stiffness are those that improve flexibility. When included as a part of a regular exercise program, flexibility exercises can also help to prevent injury. As a woman living with Rheumatoid Arthritis, I can tell you that it also helps to warm up and relieve stiffness that I feel in my joints, especially in the morning. It is important to focus on all the major muscle groups including, legs (thighs and calves), back, arms, and shoulders. The smaller muscles can be just as important to how someone feels and can be targeted specifically and regularly also. For example, my hands and wrists are very stiff from RA, so I focus on opening and closing my hands a few times before I get out of bed. I always manipulate my fingers as far back as I can (without force) and spread them apart as far as I can. I also gently roll my wrists and rock my fists forward and backward a few times.  This helps to get more blood flowing to these areas and helps my muscles and joints get ready for the tasks ahead.  This same sort of manipulation/hyper-extension can be applied GENTLY to any joints.

The next two categories are the more common and they are aerobic/endurance exercises and strength/resistance exercises.

Aerobic and Endurance These exercises should be done regularly to total 150 minutes per week for older adults. See the following link:  http://www.todaysgeriatricmedicine.com/news/ex_092210_03.shtml

This can look like 20 min/day for all seven days of the week; 30min/day for five days of the week; or 50 min/day for only three days of the week. It can be helpful for older adults to start with only ten minute segments at a time usually with significant breaks in between. For example, if they walk for ten minutes in the morning, it may not be until after dinner that they walk another ten minutes. If they prefer organized classes the class may be 30+ minutes and will fulfill their time for that day. Some activities could include, water aerobics, walking, jogging, or tennis.  Walking is the single easiest, no equipment or class necessary, exercise that you can do for yourself.  If you can only walk for five minutes, do it.  Then do it again, and again, until you reach your daily goal.  Use your assistance devices, if needed, and “Do what you can, as much as you can!”


Strength and Resistance It’s a common fallacy that strength and resistance exercises require heavy gym equipment. Everyday objects can be used for resistance; the most important of which is your own body. You can also use walls, furniture, resistance bands, hand weights and of course gym equipment.  For older adults, something as simple as a can of fruits or vegetables can be enough weight to work and strengthen your muscles. (i.e. smaller cans weigh a few ounces up to the larger cans weighing about two lbs., perfect for light resistance and weight training.)

canned-vegie4 All major muscle groups will need to be exercised and strengthened. Exercises should target all the major muscle groups and should be performed two to three times a week with at least one day in between as a rest day. If you choose to weight lift each day or more than three days per week, try alternating which muscle groups you are working so that each gets a rest day.

seniors light weightsFor example, if you work your legs on Monday, then Tuesday focus on your shoulders and arms, rest Wednesday, then Thursday shift the focus to your back and Friday your core. Then you will be free to enjoy the weekend and rest up for the next week. These exercises can help to prevent loss of bone mass and improve balance. Again, “Do what you can, as much as you can!”

91207-600x800-Weight_Shift_Exercise  chair exercise91206-522x850-Standing_Chair_Exercise

Everyone’s ability and activity level will be different, and those who have limitations should seek out the proper support and help when attempting any exercise. Please, for you and your family, don’t let it stop you from doing something. It can be challenging, and at times discouraging, but hang in there.  A little bit of work every day is much better than no work, any day. Like most things in life, your health is worth fighting for!

Information was referenced from www.agingcare.com; www.toaysgeriatricmedicine.com; and http://eldergym.com.


Ashley Gonzalez is writing for PA HOME CARE of Lancaster.  She lives in northern Pennsylvania with her husband Rich and their two beautiful daughters, Alana and Elise.  We look forward to more interesting and thoughtful articles from her.  She brings a wealth of personal knowledge as well as a degree in medical studies from Liberty University.ashley edit

Isolation and the Older Adult by Kathy Spence

May 16, 2016

Sad older woman










Recently much has been said about “sitting being the new smoking” when it comes to health risks.  For our senior population another risk has been well known in anecdotal form, but much less well documented.  That is the inherent risk associated with social isolation as it relates to chronic depression.  According to the National Institute on Health, frequent feelings of loneliness are linked to higher rates of infection, cognitive decline, cardiovascular disease, depression, morbidity and mortality.  This risk is magnified among our older population as they are facing retirement and a perceived loss of self as well as health limitations and possibly disabilities limiting their mobility and ability to do all of the things they want to do.

It doesn’t have to be this way.  Older adults, in particular, have shown an ability to thrive with a minimal level of social connectedness.  Even a small social network, church activities, volunteering, visits with family, etc. can bring a level of satisfaction much greater than the lack of same can lead to health issues, particularly depression.  However, this is not a “one size fits all” resolution.  Some folks are happy with little outside contact while others crave more activity.    This is the difference between actual social disconnectedness and perceived isolation.  One elder who appears to be socially disconnected may, in fact, thrive on a certain level of contented solitude.  Another apparently active senior may feel unsupported and not intimate in their relationships and actually perceive themself as isolated.  Ask your older loved one the following questions; “How often do you feel that you lack companionship?” “How often do you feel left out?” and “How often do you feel isolated from others?”  Their answers will be very telling.


Sad older man










So what do we do?  First and foremost, you must know the senior adult that you are concerned about.  Not just know who they are and what their physical needs are, but know them as a person.  What do they enjoy, who do they enjoy time with, what would a perfect day look like to this individual?  Now, how do we get them there?  What resources are available to the elder and their family? What is reasonable and sustainable?  For instance, if regular family time is what your senior craves, is it possible to have a standing date every week, every month, whatever works for you and your family?  If church and activities revolving around church is enjoyable, does the church have transportation available or any kind of outreach program for those at home?  If regular exercise is what’s most enjoyable, a walk can do wonders and can be done with a “buddy” for companionship and safety.  Senior centers are often a viable option and can best be approached on a temporary basis with enough time allowed for the elder to build friendships and enjoy the socialization.  Following are a few more suggestions:

*  Courses in the following, often leading to clubs or informal gatherings to do same; Cooking, Crafting, Computer/Internet, Bird-Watching, Gardening, or any other new activity.

*  Volunteering; opportunities abound across many areas of need; hospitals, churches, schools, public service organizations, also check with your local United Way.

*  Exercise programs geared specifically towards the older adult; check with your local YMCA, Office of Aging, or Senior Centers, as well as Health Clubs in your area.

The possibilities are really endless if approached from a position of what can we do, instead of what the senior is no longer able to do.  At PA HOME CARE we are happy to help in any way that we can.  We’re available by the hour or by the day and anything in between.                                                                                                                    grandparentslrg

Call us today and let’s talk @ (717) 464-2006.

PA HOME CARE of Lancaster;

“With Hearts and Hands, We Care”,

about you and the elder loved one in your life.




A Very Real Scam … Foisted onto a Local Senior (originally posted by berks lancaster lebanon link)

February 11, 2016


By berkslancasterlebanonlink on

check looks real


Old people with money. Scam artists relentlessly prey on them. Why are the elderly more susceptible and more likely to become victims of a scam? The elderly are vulnerable to scams because they tend to be too trusting, gullible, live alone and don’t have someone watching over their finances. Loneliness also plays a role. Elders are often grateful to have someone to talk to – not suspecting that the “nice man” on the phone may be preying on them.” – AgingCare


We’re taking a page from Joe Friday here when we say, “The story you are about to read is real, only the name and address has been removed to protect the innocent.”

A local senior citizen, innocently and unwittingly, responded to offer about a mystery shopper opportunity.

Here’s the beginning of this actual scam / phishing attempt.



On Feb 8, 2016 11:43 AM, “david walter” <dw0299868@gmail.com> wrote:

Hello Shopper,

How are you doing today and how has your week been? I will like to inform you of your first assignment which you are to receive in the mail today.

The payment processing department  has mailed out a check via USPS for you to carry out your first assignment and it is to be delivered today. This is regarding the

On-line Survey/Evaluation you got few days ago.


The payment you will receive has been issued in your Name as a secret shopper.

Its a check of $1,998,00


Assignment (A) Wal-Mart Evaluation:

Assignment (B) money gram Evaluation:


You will be getting a check payment totalling $1.998.00 These funds are to be used for your assignment. The Expenditure Breakdown is listed below. You are instructed to deposit/cash the payment at your Bank for record purposes and then go ahead with the Evaluations. The payment you received covers all expenditures including   evaluation, shopping and your compensation (Assignment remuneration $200.00) for the surveys.

During your Mystery Shopping experience, you will purchase items that you would normally use in your home. These purchases are yours to keep and they should not exceed the amount outlined below. You will also be using moneygram services to send the balance to another Mystery shopper to complete the assignment in full.  You want to inquire what the differences are between Local transfers and International transfers and provide their responses in your report.

****************************** ****************************** ****


(1)-How long did you wait for a Customer Service Agent?

(2)-What was the overall appearance of the store, inside and out?

(3)-Knowledge of the Customer Service Agent helping you?

(4)-Overall professionalism of the cashier’s

(5)-Reaction of personnel under pressure

(6)-Conditions of the Restrooms (Wal-Mart only)

(7)-Your comments and impressions.

****************************** ****************************** ***


Money Received ………………..$1998.00

Assignment Salary…………….. $200.00

Wal-Mart ……………………..$30. 00

Money gram transfer Charges…….. $30.00

Money gram……………………. $869,00

Ensure that money is sent using the (MONEY AVAILABLE IN MINUTES)

****************************** ****************************** ***

As a Mystery Shopper your job is to observe anything useful going on in the location that you are there to observe. Remember that you are a “Mystery Shopper”; this means that you do not let anyone know what you are doing. Make sure you observe everything that you see. You do not want to take your paperwork inside the store.  Make sure to remember what you have observed so you can make the necessary notes when you get to your car.  So then you would go ahead and make a money gram money transfer to another mystery shopper for another assignment.We want you to deduct your payment of $200.00 and have the remaining funds sent to the information below for proper preparation of our next Mystery  Shopper. (Minus the  money gram fee $20 and also the $30.00 for whatever you will be buying at Wal-Mart)

****************************** ****************************** ***

You are to send the funds to two different shopper, you are advise to have the funds send in different location



Receiver’s Name: WANDA KING……..$869,00

Address:  411 Elm St



ZIP CODE: 30080


ADDRESS. 11523 SW 126th



ZIP CODE.30008




  1. Senders Name and Sender Address:
  2. 8 Digits Money gram Transfer reference Number for both shopper.


David Walter.


David Walter


In a few days, the check arrived, delivered into the recipient’s mailbox. Here’s a scan of the envelope:

envelope looks authentic.jpg


That’s when the recipient showed the check and the envelope to us.


BE ASSURED – THIS IS A SCAM. Read this Federal Trade Commission article: “Beware of mystery shopper scams.”


Originally posted by:




From Kathy Spence at PA HOME CARE of Lancaster:

PLEASE – Don’t fall prey to these unscrupulous thieves.  Remember the old adage “If it sounds too good to be true, it probably isn’t”?  Take those words to heart.

*  Don’t open emails from people you don’t know.

*  Don’t accept checks or promises of money from people you don’t know.

*  Don’t be fooled by mail, email, or phone calls FROM institutions that you recognize, but have no idea why they would be contacting you.

As Ronald Reagan said, “Trust, but verify”.  You don’t need to have a jaded, negative view of the world, just a wary one.  If you have questions, find someone you trust and explain the situation to them.  Help and advice is available, but NOT AFTER you have become a victim.  These thieves are almost impossible to track down and even more impossible to recoup your losses from…don’t be their victim in the first place.

Kathy Spence, Co-Owner

PA HOME CARE of Lancaster

2703 Willow Street Pike, North

Willow Street, PA 17584

(717) 464-2006






Who Will Provide for Childless Boomers? by Denise Foley from www.nextavenue.org

July 28, 2015

Many will grow old without family to look after them.

“We chose a place we really like. We walk there – it’s like a park in London,” says Pam Boyer, 68, a retired magazine researcher whose husband is a freelance writer. “We got it taken care of early before it seemed morbid – or too homey,” she adds with a laugh.

‘Elder Orphans’

It wasn’t the only accommodation the Boyers made to the fact that they are childless, a circumstance an estimated one in five boomers find themselves in as they age.

One study predicts that about a quarter of boomers may become “elder orphans.” That’s a newly coined term for people who reach old age with no family or friends left, like the 81-year-old North Carolina man who made the news in May when he called 911 for food because he had no one else to turn to.

Fewer Caregivers

Family members provide about 70 percent of long-term care services, according to a survey by the American College of Financial Services. Not only are more boomers childless, those who do have children have fewer than the previous generation. Trendsetters from the start, the boomers have spawned a new phenomenon: caregiver shortage.

As of 2010, there were more than seven family caregivers for every person 80 and over. By 2030, estimates say, there will only be four and by 2050 there will be fewer than three.

The key thing is choosing someone who will enforce the decisions that you’ve already made.

— Bert Rahl, Benjamin Rose Institute on Aging

That raises the question: Who will take care of the childless boomers when they’re old?

Avoiding the Serious Questions

What alarms many experts is that it’s not the boomers who are asking that question.

“I’d say of every four people I meet, three have not made any decisions at all about their health care when they age,” says Bert Rahl, a licensed social worker and director of mental health services at the Benjamin Rose Institute on Aging in Cleveland, Ohio.

Understanding the Truth

The Boyers chose to be proactive. What made it easier: In light of their circumstances, they’d given it a lot of thought.

They knew when they married more than 30 years ago that they were never going to have children. Pam Boyer is an only child who cared for her grandmother and both her parents — her father had Parkinson’s disease, her mother, Alzheimer’s — in their later years.

“We’re not a healthy family,” she says ruefully.

And neither of them was squeamish about talking about death — even their own.

Take Charge of Your Life

So not only did the Boyers pre-plan their burial, they downloaded documents from the Internet that allowed them to create an advanced directive (a living will that spells out your wishes for end-of-life care) as well as durable power of attorney (POA) so a trusted friend could handle both health care and financial decisions for them when they couldn’t.

(Unlike an ordinary POA, a durable POA stays in effect if you’re incapacitated. The medical version of the POA is called a durable POA for health care.)

They also bought long-term care insurance to help cover expenses if they develop chronic illnesses that require treatment over a long period of time. Premiums for this kind of insurance are high — they can range, on average, from as low as $1,700 to more than $5,000 a year — but they offer the couple peace of mind that a catastrophic illness won’t bankrupt them.

Preventing Falls

They also did some preventive remodeling. They added grab bars to their bathtub and moved their washer and dryer from the basement to the main floor of their house to reduce their risk of falls. Falling is the No. 1 cause of hospitalization for older adults in the United States and a leading reason those 75 and older wind up in long-term care.

“Making your home fall-resistant is one of the best things you can do. Your injury potential goes way down,” says Louis Tenenbaum, a former carpenter and contractor who founded the Aging in Place Institute. The organization advocates for housing modifications to meet the needs of seniors who want to stay in their own homes as long as possible.

Every step the Boyers have taken to protect themselves in old age is a wise move even if you have children who say they’re ready and willing to be your caregivers, says Dr. Bruce Chernof, President and Chief Executive Officer of California-based SCAN Foundation, a nonprofit dedicated to improving the range of health care for seniors.

Finding Strong Supporters

Chernof, who himself is a married boomer with no children, says “family” needs to be defined broadly.

“It’s not just children. We all should be thinking about how we want to live our lives with dignity and independence and we should be building a circle of friends and family around us to help us realize that plan,” Chernof notes.

The key thing is choosing someone who will enforce the decisions you’ve already made, Rahl says. “It’s very important to communicate ahead of time what your wants and wishes are, and choose someone who will honor your wishes, not impose their own personal values,” he adds.

Draft Documents, Get Insurance

Having that “circle of support” isn’t enough without the conversation about what you want done when something happens to you. “Seventy percent of those over 65 are going to need long-term service, including help around the home, dressing, transportation and more,” Chernof says. “Not only should you be talking about what you want, it’s incumbent on you to have tools in place — like durable power of attorney and an advanced directive document and long-term care insurance if you can afford it — to support your circle of support when you hit a speed bump.”

Having those conversations isn’t easy.

Alice Alexander, 57, admits she’s one of those “typical people who have their head in the sand” about growing older.

But she took one step that she knows is in the right direction, though she did it for other reasons: She and her husband of three years recently moved into a co-housing condo community in downtown Durham, N.C. Like the Boyers, they’re childless.

Being There for Each Other

“I wanted to live in a community and with co-housing, community is there when you want it,” says Alexander, Executive Director of the Co-Housing Association. “I wanted one of those neighborhoods where you know your neighbors, where you remember each other’s birthdays and feel comfortable knocking on the door when you need help but you can always close the door. I think together as a group we’ll all find the courage to have the conversation, because we really do need to think about this.”

Alexander’s multigenerational co-housing neighbors — the Durham Central Park Co-Housing Community — haven’t set up a legal covenant spelling out how neighborly they’re going to be. But they have agreed that they want to be there for one another.

The plan was tested during the month of move-in, when one of their single neighbors broke her arm and couldn’t care for herself.

Rather than see her go to rehab, “We scheduled visiting with her, bringing her food, and some people volunteered to help her bathe,” Alexander says.

Revisit the Decisions

While setting plans in place for the potential and the inevitable are a good idea, they’ll sometimes require some tinkering. Over the last couple of years, the Boyers realized that asking a close friend to be their support was probably not the best idea.

“Unfortunately, he’s our age, which is not going to be a practical solution,” Pam says. “We’re going to ask an attorney to take over for us.”

Her advice: “Talk about it while you’re still feeling good and revisit it from time to time. It’s not once and done.”

To see the original article, or to search for more articles like this, follow the link below to www.nextavenue.org:


We Are Not Caring for Our Family Caregivers by Emily Gurnon for Next Avenue.org

April 28, 2015

Relatives do hard, scary tasks and deserve support, this expert says

by Emily Gurnon Caregiver giving relative medicine

Emily Gurnon is Senior Content Editor covering health for Next Avenue. Follow her on Twitter@EmilyGurnon.


Caregiver giving relative medicine

I was fortunate to be able to attend the American Society on Aging’s massive Aging in America 2015 conference in Chicago, Ill. last month. One of the most interesting and well-researched presentations I heard was by Lynn Friss Feinberg, senior strategic policy advisor for the AARP Public Policy Institute.

Feinberg has done policy analysis and applied research on family caregiving and long-term services and supports for more than three decades, according to AARP. The following are excerpts from her talk. She began by discussing how caregiving is different today than it was in the past.

Lynn Friss Feinberg:

There is greater complexity today in the caregiving role. Older people have multiple chronic conditions. Families serve as both care coordinators and service providers. They serve as social workers and nurses, without adequate training — many feeling very scared about their role because they don’t know what they’re supposed to be doing to do it right.

People are discharged quicker and sicker from hospitals today, so nearly one-half of family caregivers of adults are carrying out health-related tasks in the home. This is a huge shift from the old days.

So what are these tasks that are so scary?

Managing complex medication schedules is one. Imagine if you are working at your job, but your grandmother came home from the hospital with prescriptions for 16 different medications that had to be taken. And you can’t afford to hire help in the home, so you have to run home periodically during the day to administer those medications.

There is also bandaging and wound care, tube feedings, managing catheters, giving injections and operating medical equipment in the home. As Susan Reinhardt from AARP Public Policy Institute has said, these are tasks that would make nursing students tremble. It’s really scary, and we are not trained to do that.

More Women Working and Caregiving

There are more women in the workplace, especially older women, and women today define the provider role as not only taking care of their families but also supporting their families economically. Among 55- to 64-year-olds, women’s labor force participation increased from 41 percent in 1980 to 59 percent in 2012 and is projected to reach 67 percent by 2020.

Another difference is the changing composition of families and households. There is more long-distance caregiving. When I grew up, my grandparents lived right down the street from me. My granddaughters live in California, I live in Maryland; things are not the same. There is increasing diversity, delayed marriage and childbirth, high rates of divorce. The divorce rate of the population 50 and older doubled between 1990 and 2010.

Fewer Adult Children to Help

In addition, there are fewer adult children. The percent of those 85 and older with no adult children is projected to increase from 16 percent today to 21 percent by 2040. So even if you have one of those three great daughters that we all wish for, there’s no guarantee that they’re going to be there when you’re in old-old age.

So who will be caring for whom?

On Changing the Language of Caregiving

If I can do anything in my career now, I would like to change our terminology.

We should definitely retire the term “informal caregiver” from our vocabulary in referring to the care of frail older people by family caregivers and friends. Because family members are traditionally not paid for the help they provide to their loved one, they’re sometimes described as informal. In contrast, health care professionals and social service professionals, as well as direct care workers like home care aides, are generally described as formal caregivers because they’re paid for their services and they’ve also received training.

But the jargon of “informal” devalues the complexity of what family caregivers are doing today — suggesting that the tasks the families undertake are casual, relaxed, easygoing and simple.

Now let me ask you: Is there anything simple and easygoing about providing care to a grandparent with Alzheimer’s disease who has escalating needs and more costly care? Anything casual about an adult daughter having to take her father to use the toilet? The term “informal” disrespects family caregivers by creating an impression that the efforts of family members and friends play only a minor role in long term services and supports and health care.

In reality, it is families that do almost all the coordination, and provide that care, too.

America’s Care Gap

The U.S. is facing a care gap. The future looks unlike the past. We are facing rising demand as our population ages and shrinking families to provide supportive services.

No longer do we have what my grandparents and great grandparents have, which was seven, eight, nine siblings in their families to share the care. Although the family has historically been the major provider of care for older people with long-term services and support needs, the number of potential family caregivers has begun to inch downward.

Today, the caregiver support ratio has begun what will be a steep decline. We’re at the apex right now, then it’s going to go drastically down. In 2010, the support ratio was at its highest; there were 7.2 potential family caregivers for every person over the age of 80. But by now, in 2015, it has started the decline to 6.8 potential family caregivers for every person in the high-risk years of 80 and over.

By 2030, in just 15 years, as the boomers transition from family caregivers themselves into old age, the ratio is projected to decline even more sharply to 4 to 1. And by 2050 when all the boomers are in old age and will need help themselves, it will fall to less than 3 to 1.

These are really worrisome statistics, which brings me to my last point.

Facing Caregiving With Urgency

We need to treat family caregiving with new urgency and make it a priority on the national health care and long-term care agenda, in workplaces too. Family caregiving is one of the least appreciated, but most important, issues our country faces as we all age. But family caregiving is typically viewed as a private family issue and the responsibility of women in particular, and largely overlooked in public policy.

With the looming care gap, it’s time to ask this question: Are we asking families and close friends to do too much?

In my view, the debate should focus less on whether family or the public sector should be responsible for providing care and we should focus more on how family caregivers can be better recognized and supported if they choose to be a caregiver to keep them from burning out. And we should ensure that the choice that a family member makes does not have negative consequences for the individual or the family.

The current heavy reliance on family and friends as I’ve just described is just unsustainable in long-term care.

I want to leave with a quote from a colleague, Jonathan Rauch, who wrote an article in The Atlantic magazine called “Letting Go of My Father” in April 2010. He wrote that what we need “is for our nameless problem to be plucked out of the realm of the personal and brought into full public view, where help can find us.”



Postscript from Kathy Spence of PA HOME CARE of Lancaster:

We have found that most successful plans of care that are established for people in need in their own homes involves a “jigsaw puzzle” of supports.  Some of those supports are comprised of family and friends, we call them the family caregivers.  Some of those supports are a blending of various non-medical and medical personnel, we call them the professional caregivers.  Needs are broken down and tasked out to various members of this support team so that the overall care for the loved one is not too overwhelming for any single individual.  However, as with any plan, foreseeing all of the complexities and details in putting together a workable solution can be, in and of itself, daunting.  We encourage anybody in this situation to not be silent.  Ask for help and guidance.  Identify what is easily and conscientiously handed over to someone else to handle for you.  You may want to continue going along to doctor’s appointments, so maybe someone else can do the laundry.  You may need a medical professional to handle wound care, so maybe a non-medical caregiver can handle bathing and dressing.  “Pick the low hanging fruit” (tasks easily identifiable and assigned in their entirety) and move on to the myriad other caregiving responsibilities that all come together to provide a safe and happy season of life, in your loved one’s own home.  

50th Birthday Surprise?

March 10, 2015

Please watch the short video below; enjoy!

In co-operation with Lancaster General Hospital, we’re please to share this important message.

Why get a colonoscopy?

It could save your life…

by Dr. Dale J. Rosenberg

If you could get a test that could prevent cancer from developing, would you say no? Unfortunately, too many Americans are doing exactly that. By not following recommendations for a colonoscopy, you are missing out on a life-saving opportunity.

Dale J. Rosenberg, MD, is a physician with Regional Gastroenterology Associates of Lancaster, Ltd., specializing in gastrointestinal disorders. He is a graduate of Thomas Jefferson Medical College and is board certified in internal medicine and gastroenterology.

Colon cancer is the third leading cause of cancer-related deaths, with approximately 140,000 new cases diagnosed in this country every year. Approximately 51,000 people die from the disease annually. A New England Journal of Medicine study indicates colonoscopy could have played a life-saving role in thousands of these deaths.

Colonoscopy saves lives
Experts say the study is the best evidence yet that colonoscopy prevents deaths. Tracking patients for 20 years, the study concluded that colonoscopy cut the death rate from colorectal cancer by 53 percent in people whose physicians removed what are known as adenomatous polyps during the test.

According to federal estimates, however, only 6 in 10 adults are up-to-date in following the screening recommendations. In general, you should start screening for colorectal cancer at age 50—earlier if you have a family history of the disease or signs that you may have a problem.

What is a colonoscopy?
During a colonoscopy, your doctor examines the inside of your intestine by inserting a tube with a tiny camera into your rectum. It’s not the most pleasant of tests. You need to take strong laxatives the day before to clean out your intestine, but during the actual exam, you’ll most likely be sedated so you won’t feel a thing.

If precancerous polyps are spotted, they can be removed immediately. While not every polyp turns into cancer, nearly all colorectal cancers start out as adenomatous polyps.

Before this study, research showed that removing precancerous polyps cut the incidence of colorectal cancer. Now we know that the test saves lives—the most important statistic of any cancer screening. It can also detect at an early stage any cancer that’s present.

Along with cervical and skin cancer, colon cancer is one of the few cancers that a screening test can prevent. But the exam only works if people use it.

Some people are simply embarrassed; others are deterred by the bowel preparation, which is often the toughest part. Cost is another factor if the test is not covered by your insurance plan.

Regardless of whatever misgivings people have about colonoscopy, everyone needs to understand the life-saving potential of this test. And unlike other cancer screenings, you only need a colonoscopy every 10 years if no polyps are detected.

Talk to your doctor about colonoscopy and whether it’s time for you to have this important screening. 


You may feel groggy and a bit weak after having this screening done.  Most doctors require you to have someone along to drive for you and help you get safely home and comfortable again.  PA Home Care can help you in successfully maneuvering this important milestone.  Call us today and let’s talk.

Kathy Spence, Co-Owner

PA Home Care of Lancaster

2703 Willow Street Pike, N.

Willow Street, PA   17584

(717) 464-2006

(866) 205-0348

Sesame Honey Chicken (from 12 Tomatoes website)

January 20, 2015

Sesame Honey Chicken

Like Chinese Food but not the MSG and any other additives?

This recipe starts out very healthy, but feel free to make it your own.

Sesame Honey Chicken

Serves 6



  • 1 1/2 pounds boneless, skinless chicken breasts, cut into small cubes
  • 1 1/3 cups all-purpose flour
  • 1 1/4 cups buttermilk
  • 2/3 cup peanut or vegetable oil, for frying
  • 1 teaspoon cumin
  • 1/2 teaspoon chili powder
  • kosher salt and freshly ground pepper, to taste


  • 2/3 cup honey
  • 3 tablespoons low-sodium soy sauce
  • 3 tablespoons sesame seeds
  • 1 1/2 tablespoon cornstarch
  • 1 tablespoon apple cider vinegar
  • 1 tablespoon water
  • 1/4 teaspoon sesame oil
  • 1/4 teaspoon red pepper flakes


  1. For the sauce: in a small bowl or glass, combine water and cornstarch to make a slurry and stir until dissolved. Set slurry aside.
  2. Place honey, soy sauce, apple cider vinegar, sesame oil and red pepper flakes in a medium saucepan over medium-high heat, and bring to a boil.
  3. Slowly stir in cornstarch slurry and reduce heat to a simmer. Mix until cornstarch has cooked out and sauce has thickened, 5-10 minutes, and set aside.
  4. In a large, shallow dish, mix together flour, cumin, chili powder, salt and powder.
  5. Heat oil in a large skillet or Dutch oven over medium-high heat.
  6. Set up a bowl with the buttermilk and place next to your workstation.
  7. Piece by piece, dredge chicken cubes in flour, coat fully in buttermilk, drip off excess, and dredge again in flour and spice mixture, pressing firmly to adhere.
  8. When oil is hot enough (when splashing some water into it causes it to sizzle, but it’s not smoking or burning) add chicken cubes and cook for 4-5 minutes, flipping in the middle, or until chicken is an even golden brown and crispy.
  9. Use a slotted spoon to transfer chicken to a paper towel-lined plate.
  10. Move all chicken pieces to a large bowl and pour honey sauce over the top. Toss to coat thoroughly and add sesame seeds.
  11. Toss again and serve immediately over rice or noodles

Go Red for Women – Wear Red Day, Friday February 6th

January 15, 2015






More from the National Institute of Health


How Does Heart Disease Affect Women?

In the United States, 1 in 4 women dies from heart disease. In fact, coronary heart disease (CHD)—the most common type of heart disease—is the #1 killer of both men and women in the United States.

Other types of heart disease, such as coronary microvascular disease (MVD) and broken heart syndrome, also pose a risk for women. These disorders, which mainly affect women, are not as well understood as CHD. However, research is ongoing to learn more about coronary MVD and broken heart syndrome.

This article focuses on CHD and its complications. However, it also includes general information about coronary MVD and broken heart syndrome.

Coronary Heart Disease

CHD is a disease in which plaque (plak) builds up on the inner walls of your coronary arteries. These arteries carry oxygen-rich blood to your heart. When plaque builds up in the arteries, the condition is called atherosclerosis (ath-er-o-skler-O-sis).

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque can harden or rupture (break open).

Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina (an-JI-nuh or AN-juh-nuh).

If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.

Heart With Muscle Damage and a Blocked Artery

The picture shows the standard setup for an EKG. In figure A, a heart rhythm recording shows the electrical pattern of a normal heartbeat. In figure B, a patient lies in a bed with EKG electrodes attached to his chest, upper arms, and legs. A nurse oversees the painless procedure.

Figure A is an overview of a heart and coronary artery showing damage (dead heart muscle) caused by a heart attack. Figure B is a cross-section of the coronary artery with plaque buildup and a blood clot resulting from plaque rupture.

Plaque also can develop within the walls of the coronary arteries. Tests that show the insides of the coronary arteries may look normal in people who have this pattern of plaque. Studies are under way to see whether this type of plaque buildup occurs more often in women than in men and why.

In addition to angina and heart attack, CHD can cause other serious heart problems. The disease may lead to heart failure, irregular heartbeats called arrhythmias (ah-RITH-me-ahs), and sudden cardiac arrest (SCA).

Coronary Microvascular Disease

Coronary MVD is heart disease that affects the heart’s tiny arteries. This disease is also called cardiac syndrome X or nonobstructive CHD. In coronary MVD, the walls of the heart’s tiny arteries are damaged or diseased.

Coronary Microvascular Disease

The illustration shows the standard setup for an EKG. In figure A, a normal heart rhythm recording shows the electrical pattern of a regular heartbeat. In figure B, a patient lies in a bed with EKG electrodes attached to his chest, upper arms, and legs. A nurse monitors the painless procedure.

Figure A shows the small coronary artery network (microvasculature), containing a normal artery and an artery with coronary MVD. Figure B shows a large coronary artery with plaque buildup.

Women are more likely than men to have coronary MVD. Many researchers think that a drop in estrogen levels during menopause combined with other heart disease risk factors causes coronary MVD.

Although death rates from heart disease have dropped in the last 30 years, they haven’t dropped as much in women as in men. This may be the result of coronary MVD.

Standard tests for CHD are not designed to detect coronary MVD. Thus, test results for women who have coronary MVD may show that they are at low risk for heart disease.

Research is ongoing to learn more about coronary MVD and its causes.

Broken Heart Syndrome

Women are also more likely than men to have a condition called broken heart syndrome. In this recently recognized heart problem, extreme emotional stress can lead to severe (but often short-term) heart muscle failure.

Broken heart syndrome is also called stress-induced cardiomyopathy (KAR-de-o-mi-OP-ah-thee) or takotsubo cardiomyopathy.

Doctors may misdiagnose broken heart syndrome as a heart attack because it has similar symptoms and test results. However, there’s no evidence of blocked heart arteries in broken heart syndrome, and most people have a full and quick recovery.

Researchers are just starting to explore what causes this disorder and how to diagnose and treat it. Often, patients who have broken heart syndrome have previously been healthy.


Women tend to have CHD about 10 years later than men. However, CHD remains the #1 killer of women in the United States.

The good news is that you can control many CHD risk factors. CHD risk factors are conditions or habits that raise your risk for CHD and heart attack. These risk factors also can increase the chance that existing CHD will worsen.

Lifestyle changes, medicines, and medical or surgical procedures can help women lower their risk for CHD. Thus, early and ongoing CHD prevention is important.

More information about heart disease in women is available through the National Heart, Lung, and Blood Institute’s The Heart Truth® campaign.


®The Heart Truth is a registered trademark of the U.S. Department of Health and Human Services.


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