AAHSA Sunday: The weather, event reporting, and the shuttles

Welcome to AAHSA Chicago. It was gorgeous here today, 64 degrees as I write this after dinner. I'm here this week with a group of eight and traveled today with our Director of Nursing and Director of Wellness. The great weather and our wonderful families led us to get a late start from the Fort, so I can't comment much on today's opening speakers. I spotted Mr. Minnix outside of the Marriott but did not have the opportunity to hear his comments this afternoon, which was very disappointing for me. I consider him a bit of a celeb in my world and regretted not stopping him and saying hello and thanks when I saw him tonight.

For the afternoon session I attended (85-A) "Effective Event Reporting in a Risky Environment." This session highlighted the cost benefits of successful risk management in the long term care environment. Speakers made interesting points on unavoidable statements (compare your unavoidable statement verbiage to CMS interpretive guideline language) and the legal benefits of the family notification process. They really did stress the importance of family notification at the time of an incident and talked about methods for educating families on both community policies and the aging process in general. Education in risk management techniques is encouraged now at all levels of the organization, in many different forms. By educating staff on risk management policies, caregivers should not feel as threatened by a facility's investigation procedures and their own involvement.

I hate to mention the shuttles, but coming and going may be a bit difficult this week! The city traffic and unbalanced ebb and flow of conference traffic extended some shuttle waits to 45+ minutes tonight. Fighting a disappointed Bears crowd, thousands of sunny-day bikers and runners, and a reported crowd of 9,000+ (unverified), the buses just had some difficulty pushing all of these type A personalities from McCormick to the hotels and back.

This hotel charges $14.95 a day for internet. Shameful. Good night.

Blogging Live from AAHSA

I will be blogging live from this year's annual AAHSA convention in Chicago! The American Association of Homes and Services for the Aging holds a great conference each year, and I will post several updates regarding the learning sessions, events, and vendors.

So if you can't be there, then watch here for a few updates. When we return I will also share some of the learning documents and resources that I bring back. Also, check out The Future of Aging, AAHSA's own blog, for further updates and information.

Finally, if you happen to recognize me in Chicago(young red-headed guy), then please say hello! I look forward to a great conference and always love meeting people who visit here.

Captain Phil Harris and his Pumpkin

I had the pleasure of spending the day with Captain Phil Harris from Discovery Channel's "Deadliest Catch." Phil graciously visited with Lutheran Life Villages residents and was the V.I.P. at our first annual Foundation Crabfest.

As a hobby I carve portraits into pumpkins. Stupid human tricks. I carved Captain Phil into a pumpkin the night before and gave it to him. He and his agent were so pumped about it! It was on display for the Crabfest and Phil made it the screen saver on his phone.

Thanks to Captain Phil, his agent Russ, and the whole Lutheran Life Villages crew that made it possible.

Making Rounds Just Got Easier

I'm a real sucker for creating a new form. For all of you form-makers out there, this is usually a bad habit and a poor use of your time. While I haven't found any great resources for long term care forms, the fact is, most of the tools you make have already been created a thousand times over - good, bad, and ugly.

You know who you are.

So last month when Apple came out with the iPhone's newest operating software, I was excited to find a new feature: Voice Memos.

Now when making rounds, there is no audit form needed. No pen, no clipboard. No sitting your materials down to intervene and then forgetting where they are. It's as easy as 1-2-3.

1. As you round, use the Voice Memos application to make notations to yourself, such as, "Peerage Room 363 needs the closet door fixed."

2. Don't push STOP, push PAUSE in between notations. By pausing, you can keep the rounds to just one file. Otherwise, you may end up with 50 separate audio files at the end of the rounds.

3. When rounds are completed, go back to your computer and transcribe your Voice Memos. Because you created a single file using pause, it is easy to stop the recording in between notations or rewind if you missed something.

The Voice Memos application works well enough that it allows the Administrator to be discreet - you can talk softly into the mic and still easily capture your thoughts. And the transcription process is where the majority of time is saved. Even if you are accustomed to just making lists during rounds, you know that communicating your observations afterward can take a lot of time. Voice Memos eliminates this.

I know that the concept of snippet voice recording is far from new. The iPhone, though, has made making rounds much easier than it was in the past. I appreciate your feedback or tips on using this and other applications to improve your efficiency.

Lutheran Life Villages Goes Live

Hopefully someday I'll have more time to write about how my organization changed its name this week.

For now I'll just share our new website - Lutheran Life Villages: A Better Way of Living.

Happy CNA Week!

If you are a Certified Nursing Assistant, this message is for you.

Thanks for being a caregiver. You are essential to those you care for. Their strength often comes through you, whether through physical help or emotional response. You do something that most people could not do. You have training, experience, patience, and grace. You are there for us 24 hours a day, 365 days a year.

Thanks for all you do.

Seven Residents, One Nurse Killed in Shooting

On Sunday morning a young male walked into Pinelake Nursing and Rehabilitation in Carthage, North Carolina and began shooting.  Seven residents and one nurse were killed.  The relationship between the shooter and the community is unclear.

The New York Times article is here.

With our Emergency Preparedness plans due to the Indiana State Department of Health this week, this sure hits home.  What a nightmare - something I just don't know how you would plan for. 

I can't even imagine the counseling that will need to follow in order for this five-star community to rebound.  My team will surely pray for the residents, families, and employees this week.  If anyone reading this is aware of a broader support effort, please contact me so that I may assist.

God bless them all.

Great Housekeeping Idea

During our weekly meeting today, our Director of Environmental Services told me about a wonderful cost-saving idea he implemented. Rather than issue bags to the housekeeping staff by the case (I bet your carts have a case of 6 rolls on top), the supervisor issues one roll to each housekeeper during their morning meet-up each day. The department has seen a 40% reduction in bag purchases! A bag is sufficient for one typical day's rounds, and the staff know they can come back for more if they need them.

That's what we need in this economy. It's not cheap, it's smart.

What similar ideas have your employees brought forward in the past quarter?

These People Could Be Your Family

Today we opened a new 15-room Memory Care neighborhood for residents with early-stage Alzheimer’s disease.  Nestled within another portion of our skilled rooms, the new Memory Care is designed to test new household concepts of care delivery.  Our staff is excited to make it home for our residents (it is), and I can’t give enough thanks to all of the people that helped make it possible.

Which is what makes the next part of this story disappointing.

Last week we left the doors open for on-lookers as we moved furniture, installed fixtures, and inventoried equipment.  It was late afternoon and our Director of Maintenance and I were wrapping up for the day.  A family member from another area of the nursing home wandered in to look around. She had actually followed me in. 

“Can I ask you something?” she said.

“Of course.”  I was acquainted with this particular family member.

“You’re going to cover up the windows or these doors so we don’t have to look at these people, aren’t you?”

“Excuse me?”

“I’ve worked with these people, and we shouldn’t have to look at them.  I don’t want to see these people, I know what they do.”

I know, there are a lot of things I could have said next.  Reading what I wrote, it’s was more offensive than the way it reads.  Anyways, I was speechless.  And just to go on the record, her sentiment is exactly the opposite of how I feel, about not just long term care, but how I try to treat every person on God’s earth.  Even animals and bugs, now that I think about it.  Everything has a purpose, and the right to serve that purpose with dignity.

Our residents with Alzheimer’s disease have the disadvantage of memory loss.  Difficulty remembering their former purpose often leads to frustration and confusion.  Rather than attempt to alter this reality, we now understand that is better to direct residents down the most comfortable path than to redirect or reality-orient.  We will encourage our residents to assist us with the “activities of household living ™” that will help to give them a purpose, even if it is different than the one they remembered in an earlier stage of their life.

We will not let any resident live a life without purpose.  I hope that is the mission of many organizations such as ours.  I believe that we do the right thing by co-habitating these residents so they may receive focused programming and well-intentioned care and attention.  Looking down upon this group or any group of residents, though, is wrong, and I believe that as a resident advocate, a long term care professional, and a good Christian, that I was right in saying...   Well, it doesn’t matter.  I said the right thing.  I received a snide remark in return, but that’s okay – we do it for the residents.

National Nursing Home Week 2009

From the American Health Care Association:

AHCA is proud to announce this year's National Nursing Home Week® (NNHW) theme: "Nurturing a Love that Lasts". NNHW will be held May 10-16, 2009, beginning on Mother's Day. "Nurturing a Love that Lasts" will encourage all to think of generations of parents and grandparents nurturing future generations to carry on life and family traditions. A supportive and caring environment, such as a nursing home, nurtures and enables residents and families to continue growing, learning and teaching through various ways. Nursing home staff, residents and volunteers nurture a caring environment that values communication, relationships and partnership. Be a part of this celebration in May 2009!

Get started now and you can still be "ahead of the curve":

AHCA Planning Guide
www.baudville.com
www.positivepromotions.com
Promos on Time: "National Nursing Home Week

This is just start. Plan now so that you can also consider communications to families, recognition of nurses (National Nurses Week), and of all staff. Some communities prefer to focus on aging, wellness, or community instead of "nursing home" in order to avoid unnecessary stereotyping or generalization of residents.

Housing Market Update: Growing Impact on Senior Living Providers

The housing market continues to dominate news across the nation, with words like "morbid" and "dire" applied to the topic in news bylines. The release of year-end data from multiple sources demonstrates the impact of this crucial market on move-ins to senior living communities. Particularly CCRC's such as the property I manage have seen their primary feeder, the independent living, go from several move-ins per month to zero. This will turn out to be more than a short-term problem, as our average independent living resident stays in their apartment for several years before needing a change in level of care.

The complete article is fascinating, including hard data and charts. Be sure to check it out.

Just Imagine.

Running a 13-story nursing home.

Be a More Effective Traffic Cop

Consider the traffic cop that pulls someone over after just 30 seconds of clocking speeds. How many drivers does the officer prevent from speeding? Not many because he is busy writing a ticket (punitive).

Now consider the traffic cop that notes some drivers exceeding the speed limit by 8-12 miles per hour, but doesn't issue tickets. Most of these drivers slow down when they see the officer as their adrenaline increases and they realize the potential harm and consequence in speeding.

Sometimes you have to be a traffic cop, and every officer has to pull over the most obvious offenders, but you have a choice.

What kind of traffic cop are you?

Stimulus Package Includes $87 Billion in Medicaid Spending

AAHSA has begun breaking down the stimulus package sitting on President Obama's desk this weekend. Of relevance here it is worth noting that states will receive an additional $87 billion in Medicaid funding. Here is how much your state would receive.

Click here for more information from AAHSA.

Silver Alert System Designed to Aid in Locating Missing Seniors

At least 10 states have implemented their own missing person notification system for people with some form of mental impairment, namely Alzheimer's disease and dementia. Silver Alerts are similar to Amber Alerts, which are issued by police and broadcast by media outlets and put on Web sites when a child is believed to have been abducted and is in danger.

Indiana is currently considering implementation of the Silver Alert system. Click here to read more about Silver Alert systems across the country.

Miss Indiana Crowned Miss America

Congratulations to Indiana's own Katie Stam, who was crowned Miss America 2009. As an Indiana native I'm proud to give her a big shout out from her home state! Katie, email me to schedule a visit to the wonderful residents of Lutheran Home in Fort Wayne!

Here's the news coverage from MSNBC.

Click here to watch the You Tube video of her crowing.

Tainted Peanut Butter - Tainted Words

What Not to Say When the City Newspaper Reporter Calls:

"Residents at Lutheran Home and Concord Village, 6701 S. Anthony Blvd., are not getting all their snack options these days, said administrator Matthew Maupin. Gordon Food Service, which is their food vendor, informed them of the recall. Residents have many other snacks to choose from, Maupin said."

Which is not what I said.

Extendicare and Beverly Healthcare both gave me great training on media response. But they also both had teams. If I recall correctly, I may have had a colorful laminated card with 24-hour PR response - basically, keep your mouth shut. I see that Lutheran Hospital had a "spokesperson" in this article. That's pro.

In this case, I actually explained over the phone that sure, we had received some product related to the recall, but that we were fortunate to have our great national vendor alert us immediately and assist with product replacement.

Why did I say this, even? There was no need. I did not ask to be quoted directly, which would have been responsible, even if it didn't work. I could have offered a quick written response via email, which would have been nice documentation for both parties(what if I had been quoted waaaay out of context).

I just don't gain anything giving some one-liner about peanut butter to my adoring fan base in Fort Wayne. So anyways, just some quick advice: Don't respond off-the-cuff.

If you don't buy my advice, click here for someone else's tips (a nice Powerpoint presentation) for dealing with a media call.

Tools to Connect with the Obama Administration

As our first tech-savvy President is sworn in, a number of new and tradition dot-gov websites are beginning to embrace the latest, most-effective techniques to allow Americans to access to government. Bookmark this article detailing the top resources being run by the new Obama Administration so you can share with employees and residents or check them out yourself.

Are Your Employees Being Abused?

Over the holidays, I purchased a cabinet from Ikea, the low-budget, lots-of-assembly-required furniture and household gadgets store. One of the largest pieces was broken, and my subsequent call to customer service only revealed that Ikea is not interested in my individual satisfaction. Like most twenty-first century, I-want-it-now Americans, I exchanged heated words with the person on the receiving end of that call. I didn't get my way, and I made sure to express my sentiments - loud and rude. Was it abusive? I didn't give this worker the chance to let me know.

You have employees who feel abused by family members and residents. And if you're a member of your community leadership team, many employees blame you for not intervening. There is not a healthcare professional reading this that cannot recall a customer sitting on the other side of their desk, or standing on the other side of the bed, or even in the hallway, vociferously expressing their anger over an actual or perceived breakdown in the delivery of care. I have been sworn at, had fingers pointed in my face, and threatened. I fully understand my responsibility as a community leader, though, and I've benefited from more customer service and crisis management training than most of our employees combined. I know that I have a responsibility to find solutions and prevention through root-cause analysis, and every concern is taken seriously.

When a direct-care employee such as a nurse or a C.N.A. is verbally reprimanded by a family member, it can be perceived as a personal attack on their intelligence, proficiency, or even race and socioeconomic status. The linked article above, from a great C.N.A. forum, describes the frustration felt by many nursing staff members first-hand. I admit experiencing the same feelings as an Administrator, and the helplessness that can accompany them. Patti's article along with the subsequent reader comments, calls for a policy shift in retirement communities that holds customers accountable for their own behvior.

The topic has forced me to examine my own views and approach to conflict resolution, and I agree that families do not have the right to verbally accost employees, regardless of the situation. While difficult to craft an umbrella policy that does not discriminate against residents or breach resident rights, I recommend reviewing your process for prioritizing family and resident concerns. This process must be transparent, accessible to families, and objective. I believe that most communities have some version of this in place, but I also know how uncomfortable the worst of these situations be.

What is alarming about the conversation is that some direct-care employees are searching for their own methods to deal with situations because they feel a lack of support from their Administration. Several commenters promote calling 911 when they have been verbally (even physically) attacked by a family member. Their presumption is that communities pander to families in order to maximize revenue:

"We must stand up for ourselves if the DON won’t. If we lose the job, so what. The job wasn’t worth US. Getting hurt at work isn’t worth it. The management CAN draw the line but usually won’t cause it’s all about money- the paying customer. Mind you, I question if the payment equals the worker comp bills.

When it is family who is abusing staff, that is different. They should be banned from the facility until they are made to take an anger management course. And then they must apologize to the staff. It’s one thing to yell and hoot and scream. It’s quite another to shake and rattle and otherwise manhandle the staff. Limits must be set. Just like with kids."

So how are you going to effectively convey the right message to both employees and customers? No Administrator or Director of Nursing enjoys asking a family member to examine their own actions, but allowing your customers to act out against employees certainly sets the tone for your community. Feelings of resentment will build and employee morale will suffer greatly if leadership fails to address each individual circumstance swiftly. While I still have some introspection to conduct on the topic, I offer three tips to begin your own journey:

1. Include "Addressing Angry Customers" as part of your Abuse Prevention and Reporting In-Service. The resentment created by an angry family member can turn into retaliation - against the resident.

2. Take ownership of the concern process. I receive all written concerns in order to ensure timely, objective follow-up, and review all concerns from the previous 7 days with our Concerns Committee. The Director of Nursing and I take time each week to sit down and call several families that have expressed concern or frustration.

3. Educate employees on involuntary discharge. The average employee believes that a nursing home resident can be "kicked out" at the whim of management. Involuntary relocation is an extremely cumbersome process, and rarely executed. Why? Because forced discharges are almost never to the benefit of the resident.

OH, the resident! We almost forgot about the resident. And that is what concerns me the most about this conversation. When employees become embroiled in family onflict, the resident almost always loses. By dealing quickly and honestly with family outbursts, leadership can minimize resident stress and undue harm. Focus difficult family conversations on how actions are impacting the resident's best interests, rather than scolding or threatening discharge. A successful Administrator or Director of Nursing can advocate for both residents and employees simultaneously - and should do so every time.

I look forward to hearing from you on this topic.

Healthcare or Business Internship Opportunity

I am hosting a summer internship for a qualified Business Administration or Health Policy & Administration student. While I do not have an available Administrator-In-Training position open at this time, the opportunity to complete a Bachelor's degree internship experience with a large retirement community will be vital to graduating students hoping to earn their licenses post-graduation.

Lutheran Home is the largest not-for-profit retirement community in Fort Wayne, Indiana. Also the headquarters for Lutheran Homes, Inc., our well-established community takes a different approach to delivery of care, focusing heavily on holistic wellness programming and empowerment of all community residents. Considered home to more than 350 Fort Wayne residents, Lutheran Home offers many levels of care and endless learning opportunities for students.

Interested, qualified students should forward their resumes, in Word or PDF format, to matthewmaupin@gmail.com by March 31, 2009.

ABC News Highlights C-Diff Prevalence in Healthcare

Tonight ABC News ran a feature on the prevalence and impact of C-Diff on hospitals and nursing homes. While the focus was more on hospitals, the most interesting segment featured a clinical study on the effectiveness of bleach decontamination in the post-sub-acute setting.

Bottom Line: Consumers demand and deserve your respect, rightfully so, regarding the prevention of this infectious disease. Here are several tools for you to use when communicating to employees, residents, and families:

Mayo Clinic Guidelines on Hand Washing

Center for Disease Control (CDC) Facts on Seasonal Flu

Blogging Live from AAHSA

I'm here at my first AAHSA Annual Convention in Philadelphia, PA. It's Monday night and the crowd has filed out of the Dana Carvey show and into any number of downtown Philly joints. Of course you've already enjoyed a Philly cheese steak off the street and a good night at the Fieldhouse, and no matter where you are staying there's some historic sight of epic proportion within walking distance - we've got city hall out the window and the liberty bell within walking distance. On Saturday night I literally ran into Chris Matthews outside the Loew's hotel. A trio of high class weddings and an international media dinner drew the best-of-the-best to our part of town this convention weekend.

Dana Carvey was sub-par, an equal but disappointing replacement for the absent Aretha Franklin. Anybody that respects music would have preferred Aretha, but overall the crowd seemed to enjoy the impressions that were either Carvey circa 1994 (Swartzenager, Bush Senior, Church lady, Ross Perot) or Carvey circa 2008, which is an "impression" of every current political newsmaker, half of which require a serious stretch of the imagination.

The attendance is estimated at over 6,000, though I don't see quite that many people - as a first timer I'm still very impressed. The current presidential race and economic crisis are an intrinsic theme of the whole show, whether presented by a comedian or a nun. The audience here is the type that was abuzz today over the 900+ day the Dow had - you could feel the value of everyone's accounts rise as Monday passed. I wasn't the only one staring at my Blackberryhalf the day.

Great sessions, at least for me at this point. The speakers are experienced presenters, which is one key difference from smaller conventions. It's one thing to be a success or an expert - it's another thing to be able to tell your story really well. The educational sessions that I have attended all included multiple, related speakers. Fortunately, I chose presentations that will really help me pull some projects together, with best practice ideas presented that neither my team nor I had thought of. I am not 100% sure that all presentation materials are accessible online, but you can tell that AAHSA is at least on the way to being a green organization. You should've heard the audience clap at the opening address when it was announced that this was the last year they would be distributing tote bags.

I chose to sleep in for the John Glenn talk, but I can say that Whoopi Goldberg was decent. Her message was a bit of a stretch, and she was one up'd by Larry Minnix, AAHSA President. Minnex's discussion on the impending leadership void and the state of our government and economy was right on point and was also in line with the convention theme of "One Voice." The nun stole the show from both when she confessed to being a sinner by embracing Goldberg during the end of the opening session.

Overall, I'm excited to discover such a large, high quality convention dedicated to our profession. The polish that this convention has trulyturns the cost of sending your leadership into an investment in your organization's success.

Info from a Nursing Home & Hospital Surveyor

Finally! Check out a newer blog from "Info from a Nursing Home & Hospital Surveyor." Glad to see another perspective out there.

On Hiatus...For Awhile

It's so pleasing to see the number of great resources available for professionals in long term care to turn to online. As much as I enjoy being a part of that family, I am again planning to go "on hiatus" in an attempt to simplify both my work and personal life. I prefer to keep my blood pressure at healthy levels.

Please feel free to send me an email message, but please understand if I do not respond timely.

Thanks for reading.

Welcome Peabody Retirement Community!

I kept getting visitors from the internal website that I set up for Peabody Retirement Community last year...So I visited the page (which is being kept up to date!) and there's a link back to "The Nursing Home Administrator."

So, if you're from Peabody, thanks for visiting! Please leave a message in the comments section - It will be great to hear from you.

Administrator-In-Training

Occasionally I am contacted by a professional that is searching for an Administrator-In-Training position. While I am not in a position to host an AIT at the present time, I felt compelled to post the resume of Phil Eccles. Below is a brief bio on Mr. Eccles, and if you are interested, his resume can be downloaded by following the link at the bottom.

Please contact Mr. Eccles directly to arrange an interview.
...

Thank you for your consideration in looking at my bio and resume. As I anticipate my final career transition, it is one that is taking me onto the track that I nearly took when completing graduate school – administration of residential care of the infirm and elderly. I am in search of a seasoned administrator as an AIT preceptor who is in excellent standing with their corporation, also has an incessant curiosity and desire to improve operations and financials, is willing to be a true mentor beyond an AIT program, provides leadership in the industry in some capacity (writes articles, provides seminar sessions, serves on committees, serves as an officer, or is a regular AIT preceptor), is able to pay a stipend, and can assure me that their corporation will have a place for me upon completion of the program in good standing. I currently reside in Plainfield, IN, and would like to find a preceptor within a forty-five minute driving radius from here so that a temporary move would not be necessary until full-time placement.

As a brief bio, I have a background in sales, consultation, customer relations, and work within the healthcare industry. I completed my graduate studies at Indiana University in Health Administration, including coursework in nursing home administration. My adjunct professor was the administrator for Hooverwood in Indianapolis. The majority of my career has been in patient financial services.

My skills and achievements include:

• Ability to quickly garner trust and rapport.
• Experience working closely with medical providers, insurance carriers, and healthcare business offices.
• Knowledge of the continuum of elder care available.
• Coaching and personal development
• Interdepartmental communications and teamwork building
• Process flow analysis and recommendations, and implementation of subsequent policies and procedures
• Management by direct observation and talking with/helping employees
• Financial analysis, flexible budget determination, expense reduction, and price setting to obtain net profit goal

Thank you for reviewing my biography and attached resume. Please contact me with any questions, or to simply discuss your thoughts in directions that I may take. Even if you do not have a place for me now, I enjoy meeting people and building relationships, so I would enjoy hearing from you.

Sincerely,

Philip A. Eccles

PhilipAEccles@aol.com

Click here to download the resume.

Senate Fails to Pass Medicare Bill; Therapy Caps to Go Into Effect

Last Thursday, the Senate failed to act on HR 6331, the Medicare bill that passed overwhelmingly in the House. This Medicare bill would stave off a 10.6% rate cut for physicians beginning on July 1st. This cut was part of a 1997 balanced budget deal to trim the money going to Medicare, but physicians have been able to regularly postpone the cuts. The 1997 bill also included the Medicare Part B therapy caps that have also been either postponed or have been rendered harmless through an exceptions process. The caps would also go into effect on July 1st without this legislation.

HR 6331 would “pay” for the postponement of the physician rate cut by cutting the subsidy given to the private Medicare Advantage plans. President Bush has threatened to veto the bill if it includes this cut to the insurance plans. The administration would pay for the postponed physician rate cut by cutting other provider group reimbursement, such as eliminating the market basket rate adjustment for skilled nursing facilities and home care agencies.

The original Senate vote was 59-39 (Sen. Ted Kennedy and Sen. John McCain absent). Sen. Harry Reid changed his vote to No (final vote 58-40) so that he can bring the bill up again when the Senate returns on July 7th. Both the Senate and House are now on 4th of July recess (known as “District Work Period”).

The Bush administration gave a reprieve to the physician rate cut on Sunday. The Department of Health and Human Services will essentially freeze the current pricing system until Congress returns. Congressional aides said the freeze could last 10 days. If the legislative dispute lasts beyond the new deadline, HHS Secretary Leavitt said he hopes to retroactively pay doctors once the dispute is resolved.

The therapy caps were not included in this reprieve and will go into effect on July 1st. Congress is expected back on July 7 and it is anticipated that a vote will be taken that week.

Residents with Alzheimers Benefit from Volunteering

As Alzheimer's disease begins to wear away the memory and cognitive functioning of an older adult, caregivers are sometimes so distracted by the disease process that they fail to recognize the inner struggle of the resident. One key aspect of this struggle is the loss of contribution to society, represented as the occupational component of the six dimensions of wellness. Residents who once defined themselves by their service to their country, their community, and their family recognize their inability to perform in these roles and subsequent depression sets in.

This morning National Public Radio aired an intriguing, at least reassuring, story on a study that was pairing these residents with intergenerational volunteer opportunities. The story highlighted several assisted living residents, including a woman (with Alzheimer's disease) that was such a great volunteer that last year she won her city's volunteer of the year award - and didn't know why.

This story is a wonderful way to illustrate to caregivers the inner turmoil faced by those they love and take care of - and poses at least one solution to improving their lives, even if it's forgotten five minutes later.

National Administrative Professionals Week

Yes, it IS National Administrative Professionals Week. No, it is not National Nursing Home Administrators Week (as a few of you have Googled).

Here's the information you're looking for regarding what started as "National Secretaries Week."

Here's my brief aside on National Nursing Home Administrator's Week.

If you're looking for ideas (Wednesday is the "Day"), consider taking in something that the entire office may share. You always run the risk of leaving someone out that felt they were classified as an Administrative Professional.

Hey, these things happen all the time.

I'm going with "Business Office Donuts" plus individual thank you cards for the key Administrative staff. If I had an assistant I would go flowers, not roses, lunch sometime during the week.

But, I don't have an assistant (and wouldn't know what to do if I did).

One hundred fifteen. Don't you forget it.

I would be remiss in my duties if I did not highlight Ms. Edna Parker, from Shelbyville, Indiana, who turns 115 on Sunday. There are only 75 people alive — 64 women and 11 men — that are 110 or older.

At 115, Ms. Parker is the officially the oldest, according to Guinness.