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90-day transition plans: a safer journey to living safely at home

Posted on: April 15th, 2014 by accreditednursing No Comments

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By David Baiada


Transitional care is complicated. For any patient, the journey from acute hospital stay to living safely at home is fraught with hundreds of complex and interdependent variables. Discharge is just the first step on this journey, yet the health care providers that participate in transitions are primarily focused on discharge plans (which are really a way to get someone “out of my care and into yours”). A better route is the 90-day transition plan, which provides a road map families can follow through the maze of post-acute chaos to independence at home.

A familiar story

Anyone who has spent time in the transitional care field knows a story like this one: A client is admitted to the hospital for the third time in a year—in this case for exacerbation of heart failure (HF). She wants to go home, so her case manager provides a list of home health agencies (HHAs) — which would be helpful, except that many are no longer in business and the list includes no information about each provider’s ability to manage a successful transition. Suddenly the family decides that the client will go to her daughter’s house, but that house isn’t ready yet. They agree instead that the client will regain strength in a sub-acute setting, so she is discharged to a skilled nursing facility (SNF) with a lot of confusing paperwork, pamphlets about HF, and a few new medications (despite some confusion about what pills she’s already taking).

After 10 days of rehab at the SNF, she receives a new list of HHAs from her social worker. The list is based only on the social worker’s personal relationships and experience, rather than proven outcomes and capabilities. The client picks a home health provider and is discharged to her daughter’s house.

Day 2: While the client is being bathed, the home health nurse (RN) shows up without an appointment. It’s not a convenient time for the family, so she leaves.

Day 3: The RN returns and engages the family in developing a care plan that includes continued teaching about HF risk factors. She also gathers all the medications from the client’s purse and the hospital bag, plus the new scripts from the SNF, and puts them on the kitchen table. (WOW, what a confusing pile of pills!) When the RN calls the client’s primary care physician (PCP) to discuss and reconcile the medications, she learns that the PCP hasn’t seen the client in 18 months and didn’t know the client had been in the hospital. The PCP and RN have a quick chat to determine appropriate medications and verify the RN’s care plan, which will include three visits per week for three weeks, and also continued physical therapy (PT) at home.

Day 4: The PT calls to tell the client he’ll be making a home visit on day six. This worries the daughter because her mom is starting to lose some of the strength she regained at the SNF. The daughter calls the SNF social worker and the hospital case manager for advice. They explain there’s not much they can do, as therapy staffing can be very difficult for home health agencies, even if they promise quick availability.

Day 5: Forgetting the RN’s advice, the client has a bowl of chicken soup for dinner. When she starts to experience some edema in her ankles, she calls the home health agency to talk to the RN, but gets their answering service. After 15 minutes no one has called her back. She calls her PCP, but can only talk to the physician on call (who isn’t familiar with her care). Given the status of her HF exacerbation, the on-call physician recommends that the client go to the emergency department. She is admitted for a hospital stay to get her heart failure symptoms back under control. And so the cycle continues…

A safer solution

As we collaborate with over 1,000 acute and sub-acute facilities from coast to coast, helping to facilitate transitions for more than 10,000 clients each week, BAYADA Home Health Care has a unique opportunity to view incidents of success and failure. What we see most often are great people with good intentions, who work hard to help clients and families during periods of crisis. But the multiple handoffs, along with unpredictable and changing environmental, social, and clinical variables, make it very difficult to achieve consistently successful transitions.

Recognizing these challenges, the Alliance for Home Health Quality and Innovation has compiled current research and best practices to identify the five core elements of an effective Care Transition model. Any transitional care plan should include these five components:

  1. Patient-centered focus
  2. Medication management
  3. Communication and care coordination
  4. Timely follow-up by the health care team (including the primary care physician and home health agency)
  5. Patient-activated education and coaching

We agree that these five elements are essential to any post-discharge care plan. Additionally, what BAYADA has learned in nearly four decades of home health care experience is that industry-wide change is needed to achieve optimal results in transitional care.

First, discharge plans must be replaced with 90-day transition plans. Handoffs from one provider to the next in the chain of care are often insufficient, and more importantly, they can be confusing to the patient and family. Providers must come together to develop an effective transition plan, initiated at the hospital bedside, that coordinates services from all players in the process. The plan must include:

  • Clear assignment and communication of each provider participating in the plan (i.e. hospital, SNF, skilled HHA, non-skilled HHA, and others as needed), and confirmation that the client/family were given a choice of providers consistent with all regulatory requirements
  • Clear and correct contact information for each participant in the plan, including the above providers, plus physicians, pharmacy, insurance company, and other community resources

Next, preferred providers should be established based on service level commitments and performance. Personal relationships are no longer enough; our shared clients and families expect high-quality services, and our outcomes are increasingly driving reimbursement. The following steps help ensure high-quality service:

  • Preferred providers meet quarterly to review data, process, and goals
  • Monthly reporting of clients re-hospitalized within 30 days
  • HHA services initiated within 24 hours for at least 90% of clients
  • HHA ensuring PCP appointment within 14 days after arriving at home

The future of health care requires that we reframe the transitional care experience. Successful collaboration between providers participating in the journey of transitional care is critical to producing great outcomes, reducing costs, and supporting clients and families throughout a very challenging time in their lives. At this important moment in time, we should work together to transform the transitional care experience by developing more integrated preferred relationships focused not on simple discharge handoffs, but on comprehensive transition plans that guide shared clients through the continuum.

Aging parents: 7 warning signs of health problems

Posted on: January 17th, 2014 by accreditednursing No Comments

Concerned about your aging parents’ health? Use this guide to gauge how your aging parents are doing — and what to do if they need help. 

By Mayo Clinic Staff

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As your parents get older, how can you be sure they’re successfully taking care of themselves and staying healthy? When you visit your aging parents, ask yourself the following questions. Then, if necessary, take steps to help your aging parents maintain their independence.

1. Are your aging parents taking care of themselves?

 Pay attention to your parents’ appearance. Are their clothes clean? Do they appear to be taking good care of themselves? Failure to keep up with daily routines — such as bathing, tooth brushing and other basic grooming — could indicate dementia, depression or physical impairments.

Also pay attention to your parents’ home. Are the lights working? Is the heat on? Are the bathrooms clean? Is the yard overgrown? Any big changes in the way your parents do things around the house could provide clues to their health. For example, scorched pots could mean your parents are forgetting about food cooking on the stove. Neglected housework could be a sign of depression, dementia or other concerns.

2. Are your aging parents experiencing memory loss?

 Everyone forgets things from time to time. Modest memory problems are a fairly common part of aging, and sometimes medication side effects or underlying conditions contribute to memory loss. There’s a difference, though, between normal changes in memory and the type of memory loss associated with Alzheimer’s disease and other types of dementia. Consider your aging parents. Are memory changes limited to misplaced glasses or an occasionally forgotten appointment? Or are memory changes more concerning, such as forgetting common words when speaking, getting lost in familiar neighborhoods or being unable to follow directions? If you’re concerned about memory loss for either of your aging parents, schedule an evaluation with the doctor.

3. Are your aging parents safe in their home?

 Take a look around your parents’ home, keeping an eye out for any red flags. Do your parents have difficulty navigating a narrow stairway? Has either parent fallen recently? Are they able to read directions on medication containers?

4. Are your aging parents safe on the road?

 Driving can sometimes be challenging for older adults. If your aging parents become confused while driving or you’re concerned about their ability to drive safely, it might be time to stop driving. To help your aging parents maintain their independence, suggest other transportation options — such as taking the bus, using a van service, hiring a driver or taking advantage of other local transportation options.

5. Have your aging parents lost weight?

 Losing weight without trying could be a sign that something’s wrong. For aging parents, weight loss could be related to many factors, including:
  • Difficulty cooking. Your parents could be having difficulty finding the energy to cook, grasping the tools necessary to cook, or reading labels or directions on food products.
  • Loss of taste or smell. Your parents might not be interested in eating if food doesn’t taste or smell as good as it used to.
  • Underlying conditions. Sometimes weight loss indicates a serious underlying condition, such as malnutrition, dementia, depression or cancer.

If you’re concerned about unexplained weight loss for either of your aging parents, schedule an evaluation with the doctor.

6. Are your aging parents in good spirits?

 Note your parents’ moods and ask how they’re feeling. A drastically different mood or outlook could be a sign of depression or other health concerns. Also talk to your parents about their activities. Are they connecting with friends? Have they maintained interest in hobbies and other daily activities? Are they involved in organizations or clubs?

If you’re concerned about your parents’ moods, schedule an evaluation. Depression can be treated at any age.

7. Are your aging parents able to get around?

 Pay attention to how your parents are walking. Are they reluctant or unable to walk usual distances? Is knee or hip arthritis making it difficult to get around the house? Would either parent benefit from a cane or walker? Issues such as muscle weakness and joint pain can make it difficult to move around as well. If your parents are unsteady on their feet, they might be at risk of falling — a major cause of disability among older adults.

Taking action

 There are many steps you can take to ensure your aging parents’ health and well-being, even if you live far away. For example:
  • Share your concerns with your parents. Talk to your parents openly and honestly. Knowing that you’re concerned about their health might give your parents the motivation they need to see a doctor or make other changes. Consider including other people who care about your parents in the conversation, such as other loved ones, close friends or clergy.
  • Encourage regular medical checkups. If you’re worried about a parent’s weight loss, depressed mood, or other signs and symptoms, encourage your parent to schedule a doctor’s visit. You might offer to schedule the visit yourself or to accompany your parent to the doctor — or to find someone else to attend the visit. Ask about follow-up visits as well.
  • Address safety issues. Point out any potential safety issues to your parents — then make a plan to address the problems. For example, perhaps your parents could use assistive devices to help them reach items on high shelves or to help them stay steady on their feet. A higher toilet seat or handrails in the bathroom might help prevent falls.
  • Consider home care services. If your aging parents are having trouble taking care of themselves, perhaps you could hire someone to clean the house and run errands. A home health care aide could help your parents with daily activities such as bathing and dressing. You might also consider Meals on Wheels or other community services. If remaining at home is too challenging, you might suggest moving to an assisted living facility.
  • Contact the doctor for guidance. If your parents dismiss your concerns, consider contacting the doctor directly. Your insights can help the doctor understand what to look for during upcoming visits. Keep in mind that the doctor might need to verify that he or she has permission to speak with you about your parents’ care, which might include a signed form or waiver from your parents.
  • Seek help from local agencies. Your local agency on aging — which you can find using the Eldercare Locator, a public service of the Administration on Aging — can connect you with services in your parents’ area. For example, the county in which your parents live might have social workers who can evaluate your parents’ needs and put them in touch with pertinent services, such as home care workers and help with meals and transportation.

Sometimes aging parents won’t admit they need help around the house, and others don’t realize they need help. That’s where you come in. Remind your parents that you care about them and that you want to do what’s best to promote their health and well-being, both today and in the months and years to come.


Learn the Ins and Outs of Long-Term-Care Insurance

Posted on: January 8th, 2014 by accreditednursing No Comments

Long-term care can be incredibly expensive — so don’t get caught without the proper insurance.

By the Editors of Kiplinger’s Personal Finance magazineSee my bio, plus links to all my recent stories.

Most older Americans have no insurance to cover the incredibly expensive long-term care often necessary when chronic illness or disability strikes late in life. Nursing-home costs alone can run $70,000 to $100,000 a year. At the most expensive centers the bill can approach twice that much.

SEE ALSO: Long-Term Care Insurance Special Report

Long-term care usually involves nonmedical help with such daily tasks as bathing and dressing. Health, life and disability insurance won’t pay for that. Medicare will cover very little. But long-term-care insurance will.

People who don’t have coverage have to pay out-of-pocket until they run out of money and become eligible for Medicaid. At that point, you’re basically letting the government pick a nursing home for you.

Premiums vary wildly, depending on the insurer, the level of care you insure and your age when you buy the policy. Premiums start out at relatively modest levels for those in their 50s and then rise steeply, making the insurance costly or even prohibitive. Buying at a younger age locks in the lower rate.  To find agents who can offer quotes from several com­panies, visit the American Association for Long-Term Care Insurance Web site.

How the policies pay — or don’t pay

Generally, benefits become available once you meet three of the following conditions:

— You are unable to perform two of six basic activities of daily living (such as bathing or dressing) or you show signs of severe cognitive impairment, such as those associated with dementia.

— Your doctor or other health professional certifies that your condition is expected to last at least 90 days.

— You pay for long-term-care services for the number of days in your waiting period.

Then, depending on the beneficiary’s condition and terms of the policy, care proceeds through several stages.

Skilled care. This is medically necessary care provided by licensed professionals, such as nurses and therapists, working under the supervision of a doctor.

Intermediate care. This also requires supervision by a physician and skilled nursing care, but it is needed only intermittently.

Custodial care. This covers nursing home services. Benefits cover mainly room and board plus payments for assistance with the activities of daily living.

Home health care. Depending on the policy, benefits for home health care may range from homemaking and chore services to occupational therapy and laboratory services.

How to shop for a policy

Most people who have long-term-care coverage wish they had bought more, according to a study by LifePlans. Consider at least a three-year benefit period, which would cover the average nursing home stay. Also, a short “elimination period” (basically a deductible — see below), even though it will increase premiums, could save you out-of-pocket costs in the long run. And look for a policy that covers care in as many situations as possible: at home, in an assisted living facility, in a nursing home.

Pick the right daily benefit amount. The first decision you need to make when buying long-term-care insurance is how big a daily benefit you need. But if you rely solely on the national average, you could fall short of the cost of care in your city — or you could end up buying too large a benefit and skimping on other parts of your coverage. To figure out how much coverage you need, check out prices for facilities in your area you wouldn’t mind using. Then figure out how much of the bill you could shoulder yourself.

Find out how the policy elimination period (deductible) is satisfied. A policy with 90-day elimination period, for example, means you’re willing to pay out-of-pocket for the first 90 days of care. You can save money by finding a policy that will credit you for an entire week if you pay for care at least one day a week. Most people should consider a 60-day or 90-day waiting period, which keeps premiums manageable but limits out-of-pocket costs.

Compare how inflation protection works. Most policies offer inflation protection, so your daily maximum benefit grows but your premium doesn’t. But there are many ways inflation protection can differ. The best inflation-protection coverage automatically increases your benefit amount by 5% compounded annually, keeping pace with the rising cost of care. Such policies are pricey, often doubling the cost of coverage, but your premiums will remain the same even as the benefit amount increases.

Policies with future-purchase options, which allow you to buy additional coverage over time without medical screening, can start out costing half as much as policies that automatically increase your benefit amount. But such policies soon wind up being much more expensive. That’s because the increased benefits are generally priced at your age when you buy the extra coverage — and not how old you were when you first bought the policy.

Does the policy exclude any medical problems? Long-term-care policies carry exclusions for preexisting conditions, which usually won’t be covered for six months or a year after a policy is in force. Pass up any policy that excludes “mental disorders” unless the seller satisfies you that organically based mental disease is covered.

Stick with major insurance companies. It’s a good idea to stick with such companies, which know the business and have been stable in the past-especially because it may be decades before you need the policy and it’s tough to switch companies when you’re older and have developed medical problems.


Say yes to H2O!

Posted on: July 18th, 2013 by accreditednursing No Comments

Elderly-Couple-Exercising-With-Woman-Drinking-Glass-of-Water-e1363710745321Water and Seniors

(Original Source:

Lack of water is the number one trigger of daytime fatigue. As we age, the balance between our need for water and our thirst for water shifts. In fact, the less water an older person drinks, the less thirsty they become, leaving them open to the risk of serious dehydration and other complications.

Further, confusion over the difference between hunger and thirst intensifies over the years, making it all the more important to conscientiously drink adequate amounts of water throughout the day. One should consume atleast one cup of water for every 20 pounds of body weight daily, that’s around 6-8 glasses for the average person.

Exercise and warm weather both call for additional water intake to replace fluids lost through excessive perspiration. So, all those senior citizens who head south for retirement will need to increase water intake! Increased fiber intake among seniors, which is usually recommended for older people to aid with constipation and other health concerns, also increases the need for water. It is always important to be educated about the medications your loved ones are taking. Many medications that are diuretics will need more fluids to be consumed daily to avoid dehydration.

The human body is at least 50% water, of which 2-3 quarts are lost on a daily basis. Even bones are over 20% water! Even a 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math and reading, and difficulty staying focused. Aside from replenishing what is lost in order to hydrate the blood and tissues, water also lubricates joints, regulates temperature, and moistens the lungs to allow for breathing. Inadequate water intake over time prevents these processes from occurring, leading to arthritis, sore muscles, heavy breathing, and a higher body temperature. This means that not drinking enough water over time can result in more severe effects at an older age, which means preventable problems during what should be the golden years. In the body, water acts as a solvent, coolant, lubricant, and transport agent. Virtually nothing takes place in the body without water playing a vital role. It is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place.

Symptoms of dehydration:

  • Confusion
  • Chronic fatigue and lethargy
  • Drowsiness
  • Labored speech
  • Dry mouth
  • Sunken eyeballs
  • Unable to urinate or pass only small amounts of dark or deep yellow urine

Senior citizens are at particular risk for dehydration because their kidney function has diminished to some degree. Side effects for seniors who do not drink enough water, however, extend far beyond dehydration. Even short-term water deprivation has been known to cause chronic pain. Over time, lack of water causes loss of muscle tone, excess weight gain, slow metabolism, increased toxicity, and even organ failure. Other negative effects include arthritis, dry skin, migraines, hypertension, digestive complications, and persistent constipation.

In order to maintain health, the kidneys must excrete a minimum of ten ounces of waste per day. When water is not available, there is nothing present in which to dissolve the body’s waste products (uric acid and urea) for expulsion. As a result, they build up within the body, leading to kidney stones, while putting additional strain on the kidneys to find adequate liquid with which to expel toxins.

Considering the abundance of water in our daily lifestyles, the fact that most senior citizens are consistently dehydrated to some degree is alarming. All foods are partly composed of water; fruits and vegetables are over 75% H2O, and even bread is more than 30% water. Yet with the abundance of water in their diet, the average senior citizen still requires over two-and-a-half quarts of pure water each and every day to maintain good health. Encourage your loved ones not to wait until they are thirsty to start drinking water. At that point dehydration has already begun. Increasing your fruit and vegetable consumption is a healthy way to help keep your diet hydrated. Vegetables such as tomatoes, cucumbers, squash, lettuce, and celery are all about 90-99% water. Eating healthy has more benefits than just losing weight. It is a way to increase your energy, mood, hydration and the overall way you live your life. Eat healthy, stay hydrated, and be happy!

Hiring Home Care: Options for those Impacted by Alzheimer’s

Posted on: May 29th, 2012 by accreditednursing No Comments

Alzheimer’s Disease impacts each patient in different ways – from the onset of each symptom to the progression and duration of each disease stage.  This unpredictably makes it difficult for loved ones trying to balance their own health and wellness with the physical, emotional and financial challenges of caring for their loved one diagnosed with Alzheimer’s.

Often, family members rely on home care as the preferred solution for managing day-to-day activities of daily living for their loved one while getting a break from the demands of providing twenty four hour-a-day care and supervision.

But selecting a home care provider can be challenging as California only requires private duty home care companies to obtain a business license.  There is no governing body to enhance the quality of in-home care by enforcing standards for providers.  Not all agencies are the same!

In California, a prospective home care client has 3 options.  First, hire a caregiver directly.  The benefit is cost.  In this instance, the client will pay the lowest fees.  The risk can be great.  The caregivers are not screened by clients to include identity verification and criminal background check.  Additionally, the caregiver is NOT covered on the client’s homeowner’s policy in case of theft or injury. Often, caregivers are paid under the table and this becomes a risk for the client as well.

Second, a home care client can use a Home Care Registry.  In this model, the Agency is not the employer but acts as a placement service.  They screen applicants, but do not pay payroll taxes, cover Workers’ Compensation, and they cannot train or supervise their workers.  The cost is slightly more than hiring a caregiver directly.

Finally, a home care client can use an Employer-Model Home Care Agency.  In this instance, the cost is more but the agency minimizes risk and enhances its quality of service by conducting thorough background checks, performing new employee orientation programs, handling all payroll tax liabilities, covering the employee via Workers’ Compensation, offering caregiver benefits (such as health insurance), providers ongoing training to staff, having relief staff availability, being on-call 24/7, making supervisory visits in a client’s home, and much more.

Three years ago, the California Association for Health Services at Home (CAHSAH) recognized the predicament for families purchasing home care services and created a program for identifying quality in-home care providers.  CAHSAH created its Certified Home Care Aide Organization Program to identify agencies that meet the minimum standards as proposed in state legislative efforts to regulate the in­-home care service industry.  To learn more about CAHSAH, its Certification Program, and to find Certified Agencies in your community, visit

Consider a Career in Professional Patient Advocacy

Posted on: January 4th, 2011 by accreditednursing No Comments

I received an email this morning from the Professional Patient Advocate Institute. I clicked the link and was intrigued by the concept of patients and families hiring professionals to interact with their doctors, medical groups, insurance companies, and other healthcare providers. Its a different level advocacy and support usually provided by Geriatric Care Managers.

As Healthcare Reform takes shape, it might not be a bad idea for patients and families to have someone in their corner. Its a virtual David in the Goliath World of Healthcare. For more information, visit

Home Physical Therapy for Alzheimers

Posted on: January 3rd, 2011 by accreditednursing No Comments

Many years ago, the Alzheimer’s Community fought diligently to secure the Medicare Home Health Physical Therapy Benefit ( Although this service was technically covered by Medicare, providers encountered a high percentage of payment denials. Thus, Home Health Agencies stopped accepting these referrals for a long time until the advocates stepped up and Medicare reversed the denial trend.

As we know the old saying, ‘History Repeats Itself’. I have witnessed a similar trend in recent years and fewer Alzheimer’s patients are receiving the in-home therapies needed. This time, Home Health Agencies are faced with ADR (Additional Documentation Requests) by Medicare to substantiate and justify the services to Alzheimer’s patients. It is very difficult to demonstrate any potential progress for an Alzheimer’s patient, so Medicare has a foundation for taking back payments. From the Agency standpoint, too many ADRs can result in a RAC Audit and that’s really, really not good. So, again, Alzheimer’s patients are inadvertently targeted and may not receive the in-home care necessary.

For patients and families, go on and identify the top performing Home Care Agencies. These agencies are less likely to be impacted by the ADR & RAC Audits so they may be more capable to service an Alzheimer’s patient with their therapy needs.

How will Seniors afford Home Care when their Retirement Funds are in Jeopardy

Posted on: December 28th, 2010 by accreditednursing No Comments

Mortgage Debt, Falling Values of Stocks & Mutual Funds, Rising Medical Costs, Higher Unemployment, Social Security Cuts, Disappearing Pensions, and so on and so on. These are just some the concerns impacting a senior’s financial health. And with rising costs for medical and supportive care, how will a senior afford quality of life at home in the years to come?

A recent article posted on the Daily News’ website discusses these issues.

What’s the solution? Start taking steps now. See a financial planner and don’t wait until later to make the necessary lifestyle changes.

What do Elderlaw Attorneys do?

Posted on: December 27th, 2010 by accreditednursing No Comments

Elderlaw Attorneys are an important part of protecting an older adult’s legal and financial affairs. Too often, seniors and their families utilize an Elderlaw Attorney when problems come up. But, Elderlaw Attorneys offer valuable planning tools and resources to prevent legal and financial challenges in later life. Mitch Karasov, Esq. is a prominent Elderlaw Attorney in Los Angeles County. The information listed below was taken from and can also be found on


Elder Law Attorneys Serving Los Angeles, California

For all of us, there is a chance that we will become unable to make sound decisions as we age. If this happens to you, someone will be given the power to make decisions on your behalf — decisions regarding your medical treatment, your finances and your daily personal care. At the Law Offices of Mitchell A. Karasov, we offer comprehensive, respected elder law services to help our clients prepare for and adjust to incapacity.

If you would like to discuss elder law with a lawyer at the firm, call us today at 818.508.7192 or contact us online.

Responding to Unexpected Incapacity

Sometimes incapacity is the result of a gradual decline. Sometimes it is caused instantly by a stroke, car accident or other drastic event. If a loved one has not planned in advance for incapacity, we can help you implement a conservatorship which will give you or another trusted individual the right to make decisions on your loved one’s behalf.

Preparing for Whatever the Future May Hold

If you plan in advance for the possibility of incapacity, you can avoid enormous amounts of expense and aggravation when the time comes to put the plan into action. The firm’s attorneys offer a range of elder law services designed to help clients prepare for whatever may come:

•Estate Planning includes information on powers of attorney, wills, trusts and living wills
•Long Term Care Planning includes information on Medi-Cal and asset protection
•Elder Care Planning includes information on matching your long term care to your personal circumstances
•Probate and Trust Administration includes information on distributing assets after death
•Elder Care and Estate Conflict Resolution includes information on preventing and handling intra-family conflict
In addition, we can also help you protect a vulnerable adult who you suspect is being victimized by elder abuse. If you are being wrongly accused of elder abuse, we can provide counsel to help resolve your conflict with the individuals making the false allegations.

For an initial consultation to discuss elder law with an attorney at the firm, call today at 818.508.7192 or contact us online. We look forward to meeting with you and working with you in the future.

Established in 1996 to help seniors and their families with the many challenges facing them, the Law Offices of Mitchell A. Karasov is the first law practice in Southern California to incorporate elder care practices with elder law. We are a specialized team comprised of attorneys, nurse care managers, paralegals, and elder care experts working to protect the quality of life, financial resources and rights of elders and their families. We offer unparalleled resources and experience in healthcare, financial planning, and legal matters as they relate to both California and Federal laws.

The Law Offices of Mitchell A. Karasov offers a comprehensive approach to the practice of elder law and estate planning. We learn everything we can about each client — your medical history, legal standing, finances, even family relationships — before crafting a plan that is custom designed to fit your unique circumstances. We also work with trustees, conservators and family members who are caring for an elderly friend or relative. We handle your legal case so that you can focus on what’s most important.

The Cost of Senior Care for Employers and Employees

Posted on: December 7th, 2010 by accreditednursing No Comments

It has been well-documented that caring for an Older Relative causes economic distress to Employers & Employees alike. Employers have seen a $13.4 Billion increase in health care costs associated with employees that provide care to a older relative. Additionally, the Employer is double-dipped as productivity is lessen. For the Employee, absences can result in wage reductions and these same employees are more susceptible to illness or health decline. To combat this problem, Employers are looking at better coordination of eldercare services (through Employee Assistance Programs) and health and wellness initiatives for their employees. Home Care is a solution for Family Caregivers to avoid missing work and know their loved one is cared for. For more information on Senior Care and its impact to Employers and Employees, visit

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