ARE WE ON A HEALTH COLLISION COURSE ????

ANTIOXIDANTS, FRIEND OR FOE

Easy Insurance Helpful Tips, and easyinsurance.com hopes the following information will help you decide!


Antioxidants and Cancer Prevention: Questions and Answers
Key Points

Antioxidants protect cells from damage caused by unstable molecules known as free radicals (see Question 1&3).

Laboratory and animal research has shown antioxidants help prevent the free radical damage that is associated with cancer. However, results from recent studies in people (clinical trials) are not consistent (see Question 2).
Antioxidants are provided by a healthy diet that includes a variety of fruits and vegetables (see Question 4).

1. What are antioxidants?
Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to cancer. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals otherwise might cause. Examples of antioxidants include beta-carotene, lycopene, vitamins C, E, and A, and other substances.
2. Can antioxidants prevent cancer?
Considerable laboratory evidence from chemical, cell culture, and animal studies indicates that antioxidants may slow or possibly prevent the development of cancer. However, information from recent clinical trials is less clear. In recent years, large-scale, randomized clinical trials reached inconsistent conclusions.
3. What was shown in previously published large-scale clinical trials?
Five large-scale clinical trials published in the 1990s reached differing conclusions about the effect of antioxidants on cancer. The studies examined the effect of beta-carotene and other antioxidants on cancer in different patient groups. However, beta-carotene appeared to have different effects depending upon the patient population. The conclusions of each study are summarized below.
• The first large randomized trial on antioxidants and cancer risk was the Chinese Cancer Prevention Study, published in 1993. This trial investigated the effect of a combination of beta-carotene, vitamin E, and selenium on cancer in healthy Chinese men and women at high risk for gastric cancer. The study showed a combination of beta-carotene, vitamin E, and selenium significantly reduced incidence of both gastric cancer and cancer overall. (1)
• A 1994 cancer prevention study entitled the Alpha-Tocopherol (vitmain E)/Beta-Carotene Cancer Prevention Study (ATBC) demonstrated that lung cancer rates of Finnish male smokers increased significantly with beta-carotene and were not affected by vitamin E. (2)
• Another 1994 study, the Beta-Carotene and Retinol (vitamin A) Efficacy Trial (CARET), also demonstrated a possible increase in lung cancer associated with antioxidants. (3)
• The 1996 Physicians' Health Study I (PHS) found no change in cancer rates associated with beta-carotene and aspirin taken by U.S. male physicians. (4)
• The 1999 Women's Health Study (WHS) tested effects of vitamin E and beta-carotene in the prevention of cancer and cardiovascular disease among women age 45 years or older. Among apparently healthy women, there was no benefit or harm from beta-carotene supplementation. Investigation of the effect of vitamin E is ongoing. (5)
4. Are antioxidants under investigation in current large-scale clinical trials?
Three large-scale clinical trials continue to investigate the effect of antioxidants on cancer. The objective of each of these studies is described below. More information about clinical trails can be obtained using cancer.gov/clinicaltrials, www.clinicaltrials.gov, or the CRISP database at www.nih.gov.
• The Women's Health Study (WHS) is currently evaluating the effect of vitamin E in the primary prevention of cancer among U.S. female health professionals age 45 and older. The WHS is expected to conclude in August 2004.
• The Selenium and Vitamin E Cancer Prevention Trial (SELECT) is taking place in the United States, Puerto Rico, and Canada. SELECT is trying to find out if taking selenium and/or vitamin E supplements can prevent prostate cancer in men age 50 or older. The SELECT trial is expected to stop recruiting patients in May 2006.
• The Physicians' Health Study II (PHS II) is a follow up to the earlier clinical trial by the same name. The study is investigating the effects of vitamin E, C, and multivitamins on prostate cancer and total cancer incidence. The PHS II is expected to conclude in August 2007.
5. Will NCI continue to investigate the effect of beta-carotene on cancer?
Given the unexpected results of ATBC and CARET, and the finding of no effect of beta-carotene in the PHS and WHS, NCI will follow the people who participated in these studies and will examine the long-term health effects of beta-carotene supplements. Post-trial follow-up has already been funded by NCI for CARET, ATBC, the Chinese Cancer Prevention Study, and the two smaller trials of skin cancer and colon polyps. Post-trial follow-up results have been published for ATBC, and as of July 2004 are in press for CARET and are in progress for the Chinese Cancer Prevention Study.
6. How might antioxidants prevent cancer?
Antioxidants neutralize free radicals as the natural by-product of normal cell processes. Free radicals are molecules with incomplete electron shells which make them more chemically reactive than those with complete electron shells. Exposure to various environmental factors, including tobacco smoke and radiation, can also lead to free radical formation. In humans, the most common form of free radicals is oxygen. When an oxygen molecule (O2) becomes electrically charged or "radicalized" it tries to steal electrons from other molecules, causing damage to the DNA and other molecules. Over time, such damage may become irreversible and lead to disease including cancer. Antioxidants are often described as "mopping up" free radicals, meaning they neutralize the electrical charge and prevent the free radical from taking electrons from other molecules.
7. Which foods are rich in antioxidants?
Antioxidants are abundant in fruits and vegetables, as well as in other foods including nuts, grains and some meats, poultry and fish. The list below describes food sources of common antioxidants.
• Beta-carotene is found in many foods that are orange in color, including sweet potatoes, carrots, cantaloupe, squash, apricots, pumpkin, and mangos. Some green leafy vegetables including collard greens, spinach, and kale are also rich in beta-carotene.
• Lutein, best known for its association with healthy eyes, is abundant in green, leafy vegetables such as collard greens, spinach, and kale.
• Lycopene is a potent antioxidant found in tomatoes, watermelon, guava, papaya, apricots, pink grapefruit, blood oranges, and other foods. Estimates suggest 85 percent of American dietary intake of lycopene comes from tomatoes and tomato products.
• Selenium is a mineral, not an antioxidant nutrient. However, it is a component of antioxidant enzymes. Plant foods like rice and wheat are the major dietary sources of selenium in most countries. The amount of selenium in soil, which varies by region, determines the amount of selenium in the foods grown in that soil. Animals that eat grains or plants grown in selenium-rich soil have higher levels of selenium in their muscle. In the United States, meats and bread are common sources of dietary selenium. Brazil nuts also contain large quantities of selenium.
• Vitamin A is found in three main forms: retinol (Vitamin A1), 3,4-didehydroretinol (Vitamin A2), and 3-hydroxy-retinol (Vitamin A3). Foods rich in vitamin A include liver, sweet potatoes, carrots, milk, egg yolks and mozzarella cheese.
• Vitamin C is also called ascorbic acid, and can be found in high abundance in many fruits and vegetables and is also found in cereals, beef, poultry and fish.
• Vitamin E, also known as alpha-tocopherol, is found in almonds, in many oils including wheat germ, safflower, corn and soybean oils, and also found in mangos, nuts, broccoli and other foods.
References:
1)Blot WJ, Li JY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993;85:1483-91.
2)The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effects of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35.
3)Omenn GS, Goodman G, Thomquist M, et al. The beta-carotene and retinol efficacy trial (CARET) for chemoprevention of lung cancer in high risk populations: smokers and asbestos-exposed workers. Cancer Res 1994;54(7 Suppl):2038s-43s.
4)Hennekens CH, Buring JE, Manson JE, Stampfer M, Rosner B, Cook NR, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996;334:1145-9.
5)Lee IM, Cook NR, Manson JE. Beta-carotene supplementation and incidence of cancer and cardiovascular disease: Women's Health Study. J Natl Cancer Inst 1999;91:2102-6.

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HEALTH ISSUES, AND ALTERNATIVE MEDICINE

HEALTHY DIETS WHO CARES ANYWAY?

HELP REDUCE DOCTORS AND HOSPITAL VISITS, THUS, KEEPING THOSE CO PAYS, AND HEALTH INSURANCE PREMIUMS DOWN WHEN POSSIBLE.

EASY INSURANCE HEALTH TIPS WANTS TO SHARE SOME ADDITIONAL INFORMATION THAT YOU MAY CONSIDER, TO MAINTAIN GOOD HEALTH. READ ON.



NUTRITION - FOODS THAT FIGHT CANCER:

The majority of the research on diet and cancer suggests that eating
fruit, vegetables, whole grains and beans will lower your risk of
developing cancer.

Scientists have been studying the minerals, vitamins and phytochemicals
in plant foods. They are trying to determine precisely how and why
these foods can prevent or stop the development of tumors.
Here is a list of foods we at AICR get asked about most often. Click
each one to learn what current science can tell us about its role in
protecting our health.

Beans Berries Cruciferous Vegetables Dark Green Leafy Vegetables Flaxseed Garlic Grapes and Grape Juice Green Tea Soy Tomatoes Whole Grains
No single food or food substances can protect you against cancer, but
the right combination of foods – a predominantly plant-based diet –
can. Evidence is mounting that the minerals, vitamins and
phytochemicals in many plant foods interact to provide extra cancer
protection. This concept is called synergy.
That is why scientists recommend that at least 2/3 of your plate should
be filled with vegetables, fruit, whole grains and beans.

ALTERNATIVE MEDICINE


Acupuncture helping Urinary Incontinence

Acupuncture May Calm Overactive Bladder Reuters Health
By Amy Norton
Friday, July 15, 2005
NEW YORK (Reuters Health) -

Acupuncture performed at specific sites on
the skin may relieve some of the symptoms of overactive bladder,
according to researchers.
Their study of 85 women with the condition, marked by an overwhelming
and frequent urge to urinate, found that a few sessions of acupuncture
improved these symptoms for many.

Women who received treatment to acupuncture "points" thought to affect
bladder control, including areas in the lower back and abdomen,
reported fewer trips to the bathroom and less urgency to urinate, on
average, than their peers who had acupuncture at other sites on the
skin. Both groups reported improvement in urge incontinence, or urinary
leakage.

Though the study results aren't definitive, acupuncture may be worth a
try for women with overactive bladder, Dr. Sandra L. Emmons, the
study's lead author, told Reuters Health.
"We don't have a good treatment for overactive bladder," said Emmons,
of Oregon Health and Science University in Portland.
Given that, and the fact that acupuncture has minimal side effects, she
said she thinks there's enough evidence to suggest it as a treatment
option.

Emmons and colleague Dr. Lesley Otto report their findings in the July
issue of the journal Obstetrics & Gynecology.
Acupuncture is among the most widely practiced forms of traditional or
alternative medicine, with research showing it may aid in conditions
such as arthritis and post-surgery nausea. Practitioners use fine
needles to pierce the skin at specific points, and then manipulate the
needle by hand or, in some cases, with electrical stimulation.
According to traditional Chinese medicine, acupuncture points are
connected to pathways in the body that conduct energy, and stimulating
the points promotes the flow of this energy. Modern research has
suggested that acupuncture may work by altering signals among nerve
cells or affecting the release of various chemicals of the central
nervous system.

The procedure may help overactive bladder symptoms by decreasing nerve
stimulation to the bladder, Emmons said.
For their study, she and Otto recruited 85 women with symptoms of
overactive bladder with urge incontinence; they made at least eight
trips to the bathroom a day, often had an urgent need to urinate, and
regularly had problems with leaking.
The women were randomly assigned to receive either acupuncture to sites
associated with bladder function -- on the inner leg, low back, lower
abdomen and outer knee -- or "placebo" acupuncture to other sites on
the body.

After four weekly sessions, women who received the bladder-targeting
acupuncture had a drop-off in both frequency and urgency symptoms.

There was no clear benefit in the other acupuncture group.
On the other hand, incontinence problems waned significantly in both
groups. The reason for this is unclear, but it's possible, Emmons said,
that had the study been larger, it would have detected a benefit of the
bladder-specific acupuncture technique over the other.

It's unclear how long the effects on bladder symptoms may last. In
addition, Emmons noted, more research is needed to see whether
acupuncture could be more effective if combined with medication or
other available treatments.
SOURCE: Obstetrics & Gynecology, July 2005.

Copyright 2005 Reuters. Reuters content is the intellectual property of
Reuters. Any copying, republication or redistribution of Reuters
content, including by caching, framing or similar means, is expressly
prohibited without the prior written consent of Reuters. Reuters shall
not be liable for any errors or delays in content, or for any actions
taken in reliance thereon. Reuters, the Reuters Dotted Logo and the
Sphere Logo are registered trademarks of the Reuters group of companies
around the world.

Acupuncture May Ease Knee Arthritis, for a While Reuters Health
Friday, July 8, 2005
NEW YORK (Reuters Health) - For people with osteoarthritis of the knee,
8 weeks of acupuncture significantly decreases pain and improves
function compared with sham acupuncture or no treatment, a German study
suggests.
Dr. Claudia Witt, from Charite University Medical Centre in Berlin, and
her colleagues conducted a trial involving 294 patients ranging in age
from 50 to 75 years with osteoarthritis of the knee, who reported an
average pain intensity of 40 or more on a 100-millimeter visual analog
scale.
In the final analysis, 149 patients were assigned to acupuncture, 75 to
minimal acupuncture and 70 to a waiting list "control" group.
As the team explains in The Lancet medical journal, they administered
acupuncture according to principles of traditional Chinese medicine
using needles applied to the knee and more distant acupuncture points,
which were manually stimulated.
Minimal acupuncture treatment involved superficial insertion of needles
into distant non-acupuncture points.
Treatment was given during twelve 30-minute sessions over 8 weeks. At
that point, average scores on a standard osteoarthritis scale were 26.9
in the acupuncture group, compared with 35.8 in the minimal acupuncture
group and 49.6 in the waiting list group -- differences the
investigators call "clinically important."
By 26 weeks and 52 weeks, however, there were no longer any significant
differences between groups.
In a related commentary, Drs. Andrew Moore and Henry McQuay point out
that "using needles still has little long-term benefit."
The editorialists, both from The Churchill in Oxford, UK conclude: "We
are still some way short of having conclusive evidence that acupuncture
is beneficial in arthritis or in any other condition, other than in a
statistical or artificial way."
SOURCE: Lancet, July 9, 2005.
Acupuncture May Do Little for Fibromyalgia Reuters Health
By Alison McCook
Tuesday, July 5, 2005
NEW YORK (Reuters Health) - Acupuncture appears to relieve the chronic
pain condition fibromyalgia no better than sham acupuncture procedures,
according to new study findings.
The investigators found that people with fibromyalgia who received
acupuncture for fibromyalgia twice per week for 12 weeks were no more
likely to report decreases in pain than people who received acupuncture
designed for a different condition, needles inserted into random
locations, or simulated acupuncture without needles.
Study author Dr. Dedra Buchwald of the University of Washington in
Seattle noted that there are many possible explanations for why the
acupuncture may not have worked. The treatment may not have been
customized enough for each patient's needs. Participants also had
fibromyalgia for a long time, making them "among the most difficult
patients with this condition to treat," she said.
Alternatively, acupuncture may simply not work for fibromyalgia,
Buchwald noted. "Our study cannot distinguish between these
alternatives," she said.
Fibromyalgia is a disorder marked by widespread muscle pain and
tenderness, fatigue and sleep problems. To be diagnosed with the
condition, a person must have pain or tenderness in a number of
specific "tender points" on the body.
The cause of fibromyalgia is unknown, but researchers generally believe
that people with the condition have "amplified" pain signals due to
abnormal sensory processing in the central nervous system.
Up to 9 out of 10 people with fibromyalgia say they use at least one
type of alternative medicine, including acupuncture. To investigate how
well the treatment may work for this condition, Buchwald and her
colleagues asked 100 people with fibromyalgia to try acupuncture or
sham forms of the treatment, and to rate their pain levels up to 6
months after treatment.
"No differences in pain were identified between acupuncture and sham
acupuncture," the researchers report in the Annals of Internal Medicine.

They add that additional research should investigate how well
acupuncture treats other types of chronic pain, and the effectiveness
of other forms of alternative medicine in fibromyalgia.
SOURCE: Annals of Internal Medicine, July 2005.

Antioxidants and Cancer Prevention: Questions and Answers
Key Points Antioxidants protect cells from damage caused by unstable molecules
known as free radicals (see Question 1&3). Laboratory and animal research has shown antioxidants help prevent the
free radical damage that is associated with cancer. However, results
from recent studies in people (clinical trials) are not consistent (see
Question 2). Antioxidants are provided by a healthy diet that includes a variety of
fruits and vegetables (see Question 4).

1. What are antioxidants?
Antioxidants are substances that may protect cells from the damage
caused by unstable molecules known as free radicals. Free radical
damage may lead to cancer. Antioxidants interact with and stabilize
free radicals and may prevent some of the damage free radicals
otherwise might cause. Examples of antioxidants include beta-carotene,
lycopene, vitamins C, E, and A, and other substances.

2. Can antioxidants prevent cancer?
Considerable laboratory evidence from chemical, cell culture, and
animal studies indicates that antioxidants may slow or possibly prevent
the development of cancer. However, information from recent clinical
trials is less clear. In recent years, large-scale, randomized clinical
trials reached inconsistent conclusions.

3. What was shown in previously published large-scale clinical trials?
Five large-scale clinical trials published in the 1990s reached
differing conclusions about the effect of antioxidants on cancer. The
studies examined the effect of beta-carotene and other antioxidants on
cancer in different patient groups. However, beta-carotene appeared to
have different effects depending upon the patient population. The
conclusions of each study are summarized below.
• The first large randomized trial on antioxidants and cancer risk was
the Chinese Cancer Prevention Study, published in 1993. This trial
investigated the effect of a combination of beta-carotene, vitamin E,
and selenium on cancer in healthy Chinese men and women at high risk
for gastric cancer. The study showed a combination of beta-carotene,
vitamin E, and selenium significantly reduced incidence of both gastric
cancer and cancer overall. (1)
• A 1994 cancer prevention study entitled the Alpha-Tocopherol
(vitmain E)/Beta-Carotene Cancer Prevention Study (ATBC) demonstrated
that lung cancer rates of Finnish male smokers increased significantly
with beta-carotene and were not affected by vitamin E. (2)
• Another 1994 study, the Beta-Carotene and Retinol (vitamin A)
Efficacy Trial (CARET), also demonstrated a possible increase in lung
cancer associated with antioxidants. (3)
• The 1996 Physicians' Health Study I (PHS) found no change in cancer
rates associated with beta-carotene and aspirin taken by U.S. male
physicians. (4)
• The 1999 Women's Health Study (WHS) tested effects of vitamin E and
beta-carotene in the prevention of cancer and cardiovascular disease
among women age 45 years or older. Among apparently healthy women,
there was no benefit or harm from beta-carotene supplementation.
Investigation of the effect of vitamin E is ongoing. (5)

4. Are antioxidants under investigation in current large-scale clinical
trials?
Three large-scale clinical trials continue to investigate the effect of
antioxidants on cancer. The objective of each of these studies is
described below. More information about clinical trails can be obtained
using cancer.gov/clinicaltrials, http://www.clinicaltrials.gov/, or the CRISP
database at http://www.nih.gov/.

• The Women's Health Study (WHS) is currently evaluating the effect of
vitamin E in the primary prevention of cancer among U.S. female health
professionals age 45 and older. The WHS is expected to conclude in August 2004.

• The Selenium and Vitamin E Cancer Prevention Trial (SELECT) is
taking place in the United States, Puerto Rico, and Canada. SELECT is
trying to find out if taking selenium and/or vitamin E supplements can
prevent prostate cancer in men age 50 or older. The SELECT trial is
expected to stop recruiting patients in May 2006.

• The Physicians' Health Study II (PHS II) is a follow up to the
earlier clinical trial by the same name. The study is investigating the
effects of vitamin E, C, and multivitamins on prostate cancer and total
cancer incidence. The PHS II is expected to conclude in August 2007.

5. Will NCI continue to investigate the effect of beta-carotene on
cancer?

Given the unexpected results of ATBC and CARET, and the finding of no
effect of beta-carotene in the PHS and WHS, NCI will follow the people
who participated in these studies and will examine the long-term health
effects of beta-carotene supplements. Post-trial follow-up has already
been funded by NCI for CARET, ATBC, the Chinese Cancer Prevention
Study, and the two smaller trials of skin cancer and colon polyps.
Post-trial follow-up results have been published for ATBC, and as of
July 2004 are in press for CARET and are in progress for the Chinese
Cancer Prevention Study.

6. How might antioxidants prevent cancer?
Antioxidants neutralize free radicals as the natural by-product of
normal cell processes. Free radicals are molecules with incomplete
electron shells which make them more chemically reactive than those
with complete electron shells. Exposure to various environmental
factors, including tobacco smoke and radiation, can also lead to free
radical formation. In humans, the most common form of free radicals is
oxygen. When an oxygen molecule (O2) becomes electrically charged or
"radicalized" it tries to steal electrons from other molecules, causing
damage to the DNA and other molecules. Over time, such damage may
become irreversible and lead to disease including cancer. Antioxidants
are often described as "mopping up" free radicals, meaning they
neutralize the electrical charge and prevent the free radical from
taking electrons from other molecules.

7. Which foods are rich in antioxidants?
Antioxidants are abundant in fruits and vegetables, as well as in other
foods including nuts, grains and some meats, poultry and fish. The list
below describes food sources of common antioxidants.
• Beta-carotene is found in many foods that are orange in color,
including sweet potatoes, carrots, cantaloupe, squash, apricots,
pumpkin, and mangos. Some green leafy vegetables including collard
greens, spinach, and kale are also rich in beta-carotene.
• Lutein, best known for its association with healthy eyes, is
abundant in green, leafy vegetables such as collard greens, spinach,
and kale.
• Lycopene is a potent antioxidant found in tomatoes, watermelon,
guava, papaya, apricots, pink grapefruit, blood oranges, and other
foods. Estimates suggest 85 percent of American dietary intake of
lycopene comes from tomatoes and tomato products.
• Selenium is a mineral, not an antioxidant nutrient. However, it is a
component of antioxidant enzymes. Plant foods like rice and wheat are
the major dietary sources of selenium in most countries. The amount of
selenium in soil, which varies by region, determines the amount of
selenium in the foods grown in that soil. Animals that eat grains or
plants grown in selenium-rich soil have higher levels of selenium in
their muscle. In the United States, meats and bread are common sources
of dietary selenium. Brazil nuts also contain large quantities of
selenium.
• Vitamin A is found in three main forms: retinol (Vitamin A1),
3,4-didehydroretinol (Vitamin A2), and 3-hydroxy-retinol (Vitamin A3).
Foods rich in vitamin A include liver, sweet potatoes, carrots, milk,
egg yolks and mozzarella cheese.
• Vitamin C is also called ascorbic acid, and can be found in high
abundance in many fruits and vegetables and is also found in cereals,
beef, poultry and fish.
• Vitamin E, also known as alpha-tocopherol, is found in almonds, in
many oils including wheat germ, safflower, corn and soybean oils, and
also found in mangos, nuts, broccoli and other foods.

NEXT TIME

Clinical Trials. What's the big deal about Easyinsurance Helpful Tips exploring Cancer Clinical Trails?

CAN YOU HEAR ME NOW, ON MY WIRELESS PHONE?

CAN YOU HEAR ME NOW, ON MY WIRELESS PHONE? WHO IS PROTECTING US?

Some questions and answers regarding Wireless Telephone Safety.


Easy Insurance Helpful Tips wants you to be aware, and informed. Could
save you some insurance premium.

Check out the following information:

Wireless telephones are hand-held phones with built-in antennas, often
called cell, mobile, or PCS phones. These phones are popular with
callers because they can be carried easily from place to place.

Wireless telephones are two-way radios. When you talk into a wireless
telephone, it picks up your voice and converts the sound to
radiofrequency energy (or radio waves). The radio waves travel through
the air until they reach a receiver at a nearby base station. The base
station then sends your call through the telephone network until it
reaches the person you are calling.

When you receive a call on your wireless telephone, the message travels
through the telephone network until it reaches a base station close to
your wireless phone. Then the base station sends out radio waves that
are detected by a receiver in your telephone, where the signals are
changed back into the sound of a voice.

The Federal Communications Commission (FCC) and the Food and Drug
Administration (FDA) each regulate wireless telephones. FCC ensures
that all wireless phones sold in the United States follow safety
guidelines that limit radiofrequency (RF) energy. FDA monitors the
health effects of wireless telephones. Each agency has the authority to
take action if a wireless phone produces hazardous levels of RF energy.
FDA derives its authority to regulate wireless telephones from the
Radiation Control provisions of the Federal Food, Drug, and Cosmetic
Act (originally enacted as the Radiation Control for Health and Safety
Act of 1968). [http://www.fda.gov/cdrh/comp/eprc.html].
FCC derives its authority to regulate wireless telephones from the
National Environmental Policy Act of 1969 (NEPA) and the
Telecommunications Act of 1996 [http://www.fcc.gov/telecom.html].


QUESTIONS AND ANSWERS

What about children using wireless phones?

The scientific evidence does not show a danger to users of wireless
phones, including children and teenagers. If you want to take steps to
lower exposure to radiofrequency energy (RF), the measures described
above would apply to children and teenagers using wireless phones.
Reducing the time of wireless phone use and increasing the distance
between the user and the RF source will reduce RF exposure.
Some groups sponsored by other national governments have advised that
children be discouraged from using wireless phones at all. For example,
the government in the United Kingdom distributed leaflets containing
such a recommendation in December 2000. They noted that no evidence
exists that using a wireless phone causes brain tumors or other ill
effects. Their recommendation to limit wireless phone use by children
was strictly precautionary; it was not based on scientific evidence
that any health hazard exists.

Do wireless phones pose a health hazard?

The available scientific evidence does not show that any health
problems are associated with using wireless phones. There is no proof,
however, that wireless phones are absolutely safe. Wireless phones emit
low levels of radiofrequency energy (RF) in the microwave range while
being used. They also emit very low levels of RF when in the stand-by
mode. Whereas high levels of RF can produce health effects (by heating
tissue), exposure to low level RF that does not produce heating effects
causes no known adverse health effects. Many studies of low level RF
exposures have not found any biological effects. Some studies have
suggested that some biological effects may occur, but such findings
have not been confirmed by additional research. In some cases, other
researchers have had difficulty in reproducing those studies, or in
determining the reasons for inconsistent results.

What is FDA's role concerning the safety of wireless phones?

Under the law, FDA does not review the safety of radiation-emitting
consumer products such as wireless phones before they can be sold, as
it does with new drugs or medical devices. However, the agency has
authority to take action if wireless phones are shown to emit
radiofrequency energy (RF) at a level that is hazardous to the user. In
such a case, FDA could require the manufacturers of wireless phones to
notify users of the health hazard and to repair, replace or recall the
phones so that the hazard no longer exists.
Although the existing scientific data do not justify FDA regulatory
actions, FDA has urged the wireless phone industry to take a number of
steps, including the following:
Support needed research into possible biological effects of RF of the
type emitted by wireless phones; Design wireless phones in a way that minimizes any RF exposure to the user that is not necessary for device function; and Cooperate in providing users of wireless phones with the best possible information on possible effects of wireless phone use on human health.

FDA belongs to an interagency working group of the federal agencies
that have responsibility for different aspects of RF safety to ensure
coordinated efforts at the federal level. The following agencies belong
to this working group:

National Institute for Occupational Safety and Health Environmental Protection Agency Federal Communications Commission Occupational Safety and Health Administration National Telecommunications and Information Administration
The National Institutes of Health participates in some interagency
working group activities, as well.

FDA shares regulatory responsibilities for wireless phones with the
Federal Communications Commission (FCC). All phones that are sold in
the United States must comply with FCC safety guidelines that limit RF
exposure. FCC relies on FDA and other health agencies for safety
questions about wireless phones.
FCC also regulates the base stations that the wireless phone networks
rely upon. While these base stations operate at higher power than do
the wireless phones themselves, the RF exposures that people get from
these base stations are typically thousands of times lower than those
they can get from wireless phones. Base stations are thus not the
primary subject of the safety questions discussed in this document.
What kinds of phones are the subject of this update?

The term “wireless phone” refers here to hand-held wireless phones with
built-in antennas, often called “cell,” “mobile,” or “PCS” phones.
These types of wireless phones can expose the user to measurable
radiofrequency energy (RF) because of the short distance between the
phone and the user’s head. These RF exposures are limited by Federal
Communications Commission safety guidelines that were developed with
the advice of FDA and other federal health and safety agencies. When
the phone is located at greater distances from the user, the exposure
to RF is drastically lower because a person's RF exposure decreases
rapidly with increasing distance from the source. The so-called
"cordless phones," which have a base unit connected to the telephone
wiring in a house, typically operate at far lower power levels, and
thus produce RF exposures well within the FCC's compliance limits.

What are the results of the research done already?

The research done thus far has produced conflicting results, and many
studies have suffered from flaws in their research methods. Animal
experiments investigating the effects of radiofrequency energy (RF)
exposures characteristic of wireless phones have yielded conflicting
results that often cannot be repeated in other laboratories. A few
animal studies, however, have suggested that low levels of RF could
accelerate the development of cancer in laboratory animals. However,
many of the studies that showed increased tumor development used
animals that had been genetically engineered or treated with
cancer-causing chemicals so as to be pre-disposed to develop cancer in
the absence of RF exposure. Other studies exposed the animals to RF for
up to 22 hours per day. These conditions are not similar to the
conditions under which people use wireless phones, so we don’t know
with certainty what the results of such studies mean for human health.

Three large epidemiology studies have been published since December
2000. Between them, the studies investigated any possible association
between the use of wireless phones and primary brain cancer, glioma,
meningioma, or acoustic neuroma, tumors of the brain or salivary gland,
leukemia, or other cancers. None of the studies demonstrated the
existence of any harmful health effects from wireless phone RF
exposures. However, none of the studies can answer questions about
long-term exposures, since the average period of phone use in these
studies was around three years.

What research is needed to decide whether RF exposure from wireless
phones poses a health risk?

A combination of laboratory studies and epidemiological studies of
people actually using wireless phones would provide some of the data
that are needed. Lifetime animal exposure studies could be completed in
a few years. However, very large numbers of animals would be needed to
provide reliable proof of a cancer promoting effect if one exists.
Epidemiological studies can provide data that is directly applicable to
human populations, but 10 or more years’ follow-up may be needed to
provide answers about some health effects, such as cancer. This is
because the interval between the time of exposure to a cancer-causing
agent and the time tumors develop - if they do - may be many, many
years. The interpretation of epidemiological studies is hampered by
difficulties in measuring actual RF exposure during day-to-day use of
wireless phones. Many factors affect this measurement, such as the
angle at which the phone is held, or which model of phone is used.

What is FDA doing to find out more about the possible health effects of
wireless phone RF?

FDA is working with the U.S. National Toxicology Program and with
groups of investigators around the world to ensure that high priority
animal studies are conducted to address important questions about the
effects of exposure to radiofrequency energy (RF).

FDA has been a leading participant in the World Health Organization
International Electromagnetic Fields (EMF) Project since its inception
in 1996. An influential result of this work has been the development of
a detailed agenda of research needs that has driven the establishment
of new research programs around the world. The Project has also helped
develop a series of public information documents on EMF issues.

FDA and the Cellular Telecommunications & Internet Association (CTIA)
have a formal Cooperative Research and Development Agreement (CRADA) to
do research on wireless phone safety. FDA provides the scientific
oversight, obtaining input from experts in government, industry, and
academic organizations. CTIA-funded research is conducted through
contracts to independent investigators. The initial research will
include both laboratory studies and studies of wireless phone users.
The CRADA will also include a broad assessment of additional research
needs in the context of the latest research developments around the
world.

What steps can I take to reduce my exposure to radiofrequency energy
from my wireless phone?

If there is a risk from these products--and at this point we do not
know that there is--it is probably very small. But if you are concerned
about avoiding even potential risks, you can take a few simple steps to
minimize your exposure to radiofrequency energy (RF). Since time is a
key factor in how much exposure a person receives, reducing the amount
of time spent using a wireless phone will reduce RF exposure.
If you must conduct extended conversations by wireless phone every day,
you could place more distance between your body and the source of the
RF, since the exposure level drops off dramatically with distance. For
example, you could use a headset and carry the wireless phone away from
your body or use a wireless phone connected to a remote antenna
Again, the scientific data do not demonstrate that wireless phones are
harmful. But if you are concerned about the RF exposure from these
products, you can use measures like those described above to reduce
your RF exposure from wireless phone use.


Some groups sponsored by other national governments have advised that
children be discouraged from using wireless phones at all. For example,
the government in the United Kingdom distributed leaflets containing
such a recommendation in December 2000. They noted that no evidence
exists that using a wireless phone causes brain tumors or other ill
effects. Their recommendation to limit wireless phone use by children
was strictly precautionary; it was not based on scientific evidence
that any health hazard exists.

What about wireless phone interference with medical equipment?

Radiofrequency energy (RF) from wireless phones can interact with some
electronic devices. For this reason, FDA helped develop a detailed test
method to measure electromagnetic interference (EMI) of implanted
cardiac pacemakers and defibrillators from wireless telephones. This
test method is now part of a standard sponsored by the Association for
the Advancement of Medical instrumentation (AAMI). The final draft, a
joint effort by FDA, medical device manufacturers, and many other
groups, was completed in late 2000. This standard will allow
manufacturers to ensure that cardiac pacemakers and defibrillators are
safe from wireless phone EMI.

FDA has tested hearing aids for interference from handheld wireless
phones and helped develop a voluntary standard sponsored by the
Institute of Electrical and Electronic Engineers (IEEE). This standard
specifies test methods and performance requirements for hearing aids
and wireless phones so that that no interference occurs when a person
uses a “compatible” phone and a “compatible” hearing aid at the same
time. This standard was approved by the IEEE in 2000.
FDA continues to monitor the use of wireless phones for possible
interactions with other medical devices. Should harmful interference be
found to occur, FDA will conduct testing to assess the interference and
work to resolve the problem.

Which other federal agencies have responsibilities related to potential
RF health effects?

Certain agencies in the Federal Government have been involved in
monitoring, researching or regulating issues related to human exposure
to RF radiation. These agencies include the Food and Drug
Administration (FDA), the Environmental Protection Agency (EPA), the
Occupational Safety and Health Administration (OSHA), the National
Institute for Occupational Safety and Health (NIOSH), the National
Telecommunications and Information Administration (NTIA) and the
Department of Defense (DOD).

By authority of the Radiation Control for Health and Safety Act of
1968, the Center for Devices and Radiological Health (CDRH) of the FDA
develops performance standards for the emission of radiation from
electronic products including X-ray equipment, other medical devices,
television sets, microwave ovens, laser products and sunlamps. The CDRH
established a product performance standard for microwave ovens in 1971
limiting the amount of RF leakage from ovens. However, the CDRH has not
adopted performance standards for other RF-emitting products. The FDA
is, however, the lead federal health agency in monitoring the latest
research developments and advising other agencies with respect to the
safety of RF-emitting products used by the public, such as cellular and
PCS phones.

The FDA's microwave oven standard is an emission standard (as opposed
to an exposure standard) that allows specific levels of microwave
leakage (measured at five centimeters from the oven surface). The
standard also requires ovens to have two independent interlock systems
that prevent the oven from generating microwaves the moment that the
latch is released or the door of the oven is opened. The FDA has stated
that ovens that meet its standards and are used according to the
manufacturer's recommendations are safe for consumer and industrial
use. More information is available from: www.fda.gov/cdrh.

The EPA has, in the past, considered developing federal guidelines for
public exposure to RF radiation. However, EPA activities related to RF
safety and health are presently limited to advisory functions. For
example, the EPA now chairs an Inter-agency Radiofrequency Working
Group, which coordinates RF health-related activities among the various
federal agencies with health or regulatory responsibilities in this
area.

OSHA is responsible for protecting workers from exposure to hazardous
chemical and physical agents. In 1971, OSHA issued a protection guide
for exposure of workers to RF radiation [29 CFR 1910.97]. However, this
guide was later ruled to be only advisory and not mandatory. Moreover,
it was based on an earlier RF exposure standard that has now been
revised. At the present time, OSHA uses the IEEE and/or FCC exposure
guidelines for enforcement purposes under OSHA's "general duty clause"
(for more information see:
http://www.osha-slc.gov/SLTC/radiofrequencyradiation/index.html
NIOSH is part of the U.S. Department of Health and Human Services. It
conducts research and investigations into issues related to
occupational exposure to chemical and physical agents. NIOSH has, in
the past, undertaken to develop RF exposure guidelines for workers, but
final guidelines were never adopted by the agency. NIOSH conducts
safety-related RF studies through its Physical Agents Effects Branch in
Cincinnati,Ohio.

The NTIA is an agency of the U.S. Department of Commerce and is
responsible for authorizing Federal Government use of the RF
electromagnetic spectrum. Like the FCC, the NTIA also has NEPA
responsibilities and has considered adopting guidelines for evaluating
RF exposure from U.S. Government transmitters such as radar and
military facilities.

The Department of Defense (DOD) has conducted research on the
biological effects of RF energy for a number of years. This research is
now conducted primarily at the U.S. Air Force Research Laboratory
located at Brooks Air Force Base, Texas. The DOD Web site for RF
biological effects information is listed with other sites in
conjunction with a question on other sources of information, below.

Who funds and carries out research on the biological effects of RF
energy?

Research into possible biological effects of RF energy is carried out
in laboratories in the United States and around the world. In the U.S.,
most research has been funded by the Department of Defense, due to the
extensive military use of RF equipment such as radar and high-powered
radio transmitters. In addition, some federal agencies responsible for
health and safety, such as the Environmental Protection Agency (EPA)
and the U.S. Food and Drug Administration (FDA), have sponsored and
conducted research in this area. At the present time, most of the
non-military research on biological effects of RF energy in the U.S. is
being funded by industry organizations. More research is being carried
out overseas, particularly in Europe.

In 1996, the World Health Organization (WHO) established the
International EMF Project to review the scientific literature and work
towards resolution of health concerns over the use of RF technology.
WHO maintains a Web site that provides extensive information on this
project and about RF biological effects and research
(www.who.ch/peh-emf).

Easy Insurance Helpful Tips hopes you "heard" that.

WHERE SHOULD WE HOUSE OUR SENIORS??

WHAT IS GOING ON WITH SENIOR HOUSING COST?

DOES OUR SOCIETY EVEN CARE ABOUT OUR SENIORS? WE CARE, BUT WHAT ARE WE DOING ABOUT THE GROWING PROBLEM?

Here are some Easy Insurance Helpful Tips and Answers.

Read on, I hope the following information will help in some way.

We all need guidance for the help our Seniors need. It is very important to understand the following information;


SENIOR HOUSING COSTS

Payment Options

There are various ways of paying for senior housing and long-term care;
some of the most frequently accessed sources are summarized here.Private Funds Medicaid Medicare Long-Term Care Insurance Supplemental Security Income (SSI) Private Funds
Most people pay for independent living, assisted living, and CCRCs out
of their own pockets with private funds. There are some states which
accept Medicaid for assisted living, but there is currently no program
on the federal level, and private funds still account for approximately
90 percent of assisted living payments. About one-third of long-term
care at nursing facilities is paid with private funds.


Medicaid

What is Medicaid?
As defined in Title XIX of the Social Security Act, Medicaid is a joint
Federal-State program which pays for medical services to eligible needy
and vulnerable families and individuals. The State must offer basic
services in order to receive Federal matching funds, and the Medicaid
program varies from State to State.

Qualifications for Medicaid

Medicaid is intended to pay for health and long-term care for persons
with limited financial resources. Common services include, but are not
limited to:
outpatient hospital services inpatient hospital services nursing facility services for persons aged 21 or older prenatal care physician services medical and surgical dental services home health and community-based care for persons eligible for nursing
facility services laboratory and x-ray services nurse-midwife services pediatric and family nurse practitioner services family planning services and supplies Payment for Medicaid ServicesMedicaid is a vendor payment program, and States may pay for Medicaid
services through HMOs or directly to providers. The Medicaid payment
rates must be accepted as full payment in full. States may elect to
impose deductibles, coinsurance, or co-payments on Medicaid recipients
for some services. Medicaid and Nursing Home CareMedicaid currently pays for 60% of nursing facility care.

Medicaid and Assisted Living / Home and Community-Based Services

Medicaid pays for only about 10 percent of assisted living services,
the majority being paid for with private funds. Several states have
adopted Medicaid waiver programs to earmark funds towards assisted
living, and this trend is expected to continue as cost containment
remains a critical issue for both State and Federal governments.

Medicare

What is Medicare?

As defined in Title XVIII of the Social Security Act, Medicare ("Health
Insurance for the Aged and Disabled") is a Federal health insurance
program for aged (65+) and certain disabled individuals (e.g., persons
with end-stage renal disease (ESRD) who require dialysis or a kidney
transplant), regardless of income. Medicare is comprised of two parts, defined as follows:
Part A (Hospital Insurance): Provided automatically to individuals 65
and over who are entitled to Social Security, and to disabled persons
who have received such benefits for at least 24 months. The health
services covered under Part A are: Skilled Nursing Facility (SNF) Care: Covered by Part A only if it

follows within 30 days of a hospitalization of three or more days, and
is certified as medically necessary. Medicare does generally not pay
for long-term care in a nursing facility, and the number of SNF days
provided for is limited to 100 days, with a co-payment required for
days 21 to 100.

Home Health Agency Care: Can be furnished by a home health agency at
the residence of the beneficiary. Part A may also pay for some medical
equipment and medical supplies.
Hospice Care: Provided to terminally ill individuals who have a life
expectancy of six months or less, and who choose to forgo standard
medical treatment.

Inpatient Hospital Care: Includes coverage of the costs for most
hospital services, including operating room, intensive care, laboratory
tests, inpatient prescription drugs, X-rays, rehabilitation, long-term
hospitalization,, meals, and semi-private room. Part B (Supplementary Medical Insurance):

Provided to almost all U.S.
residents 65 or older, certain aliens 65 or over, and disabled
individuals entitled to Part A. Part B coverage requires payment of a
monthly premium, and primarily covers physician services. Also covered
by Part B are non-physician services, including diagnostic tests,
ambulance services, clinical laboratory tests, flu vaccinations, and
some therapy services.

Long-Term Care Insurance
What is Long-Term Care Insurance?
Long-term care insurance covers the cost of long-term care in certain
types of care facilities, depending upon the policy. Policies may cover
stay in licensed nursing facilities and home health care. Often, those
persons with a sizable asset base may wish to purchase a policy to
protect these assets.

Where can Long-Term Care Insurance be Purchased?
Long-term care policies are sold by private insurance companies (not
all insurance firms offer this type), through agents, mail, and various
organizations. Another source is employers, who offer this coverage as
a benefit to employees and their parents. An insurance company must be
licensed in your state to sell long-term care insurance.

How Much do Policies Cost?

Premiums for Long-Term Care Insurance are based on the age of the
person at the time of purchase, the benefit amount, the benefit time
period, elimination or deductible, and special options (i.e. inflation
adjustment, non-forfeiture benefits and spousal discounts).

WHAT IS SSI

SSI is a monthly cash payment from the government for eligible
individuals in financial need who are aged 65 or older or persons who
are blind or have a disability (including children). Typically, a
person eligible for SSI payments has no or little income, total assets
of less than a few thousand dollars (within certain limits set out in
regulations, not including a home used for self support, automobile,
values of household goods, personal effects, and life insurance), has
U.S. citizenship or qualified alien status, and U.S. residency. In certain circumstances, the SSI payment may be used towards some
housing and care needs of the individual.

The SSI program is run by the Social Security Administration
(http://www.ssa.gov/), but the SSI is not the same as Social Security. Money
for SSI payments comes from the general fund of the U.S. Treasury, and
some states add money to the federal payment.

Independent Living Services

Independent Living, often referred to as Retirement Communities,
Congregate Living or Senior Apartments, are designed specifically for
independent senior adults who want to enjoy a lifestyle filled with
recreational, educational and social activities with other seniors.

These communities are designed for seniors who are able to live on
their own, but desire the security and conveniences of community
living. Some communities offer an enriched lifestyle with organized
social and recreational programs as a part of everyday activities
(Congregate Living or Retirement Communities), while others provide
housing with only a minimal amount of amenities or services (Senior
Apartments).

Some Independent Living Communities offer abundant recreational
activities which may include swimming pool/spas, exercise facilities,
Clubhouse/Lounge and Library/ Reading Lounges. Communities may also
provide laundry facilities, linen service, meals or access to meals,
local transportation, and planned social activities. Communities can be
either "Age Inclusive" or "Age Exclusive." Age Inclusive communities
attract retirees, but do not have age-requirements whereas Age
Exclusive communities do have senior age-requirements (usually age 55
and older).

Cost

Prices are generally dependent upon the local market. Most communities
that provide services are market rate, but some subsidized senior
apartments cater to seniors with limited incomes.
Plans can include housekeeping, laundry, van or scheduled
transportation. Most communities with these services also provide at
least one group activity per day.
Regulation

Because these communities are not licensed by local, state or federal
agencies, there is no formal regulation. In those communities that
provide services and activities, the rules are set and governed by the
management company providing the services. In other communities, an
on-site or off-site manager will help address any problems.

Payment Options

Private Funds are most often used, although some senior apartments are
subsidized and accept Section 8 vouchers. Medicare and Medicaid do not
cover payment since no healthcare is provided.

Care

Health care is not provided with your normal fees, but many communities
will allow you to pay for a home health aide or nurse to come into your
apartment to assist you with medicines and personal care.

Assisted Living

Assisted Living provides a special combination of residential housing,
personalized supportive services and healthcare. These residential
settings maximize independence, but do not provide skilled nursing
care. Assisted Living may offer the same features as independent living
communities, with the added assistance of personal care. It is designed
to meet the individual needs of those requiring help with activities of
daily living, but do not need the skilled medical care provided in a
nursing home.

Services

Assisted Living Communities can be free standing, part of a Continuing
Care Community that provides independent, assisted and nursing care,
affiliated with a nursing home, or often are specialized services
brought into independent retirement communities. There are a variety of
names used to describe Assisted Living facilities; many specialized to
certain regions of the country. Board and Care, Residential Care
Facilities, Community Based Retirement Facilities, Personal Care, Adult
Living Facilities, Adult Foster Care, etc. are all examples of Assisted
Living facilities. However, the generic term throughout the country is
"Assisted Living."

Care

These residential settings maximize independence, but do not provide
skilled nursing care. Assisted Living offers the same features as
retirement communities, with the added assistance of personal care. It
is designed to meet the individual needs of those requiring help with
activities of daily living, but does not need the skilled medical care
provided in a nursing home. Although the variety of services and level
of care will vary, most communities provide assistance with dressing,
grooming, bathing, and other daily activities. Assistance with
medications differs according to state regulations; this is reflected
on each community-listing page by "supervision, administration, or
monitoring."

Cost

Costs for Assisted Living depend on the number of services and
accommodations that they offer. The facilities charges will reflect the
number of services that you will have access to. Most plans include
meals and laundry, but some may limit the number of meals per month.

Payment Options

Most Assisted Living Communities accept private pay only; however, in
some states there is assistance with payment. Some long-term care
insurance policies may cover Assisted Living. This type of information
is best determined on an individual basis.

Regulation

Assisted Living facilities are regulated and licensed at the state
level. Each state does so according to its own laws-there are no
federal regulations on Assisted Living.


Nursing Homes Services

Nursing Homes, or Skilled Nursing Facilities, are designed for seniors
who are in need of 24-hour nursing care. Nursing Facilities provide
many of the same residential components of other senior care options
including room and board, personal care, protection supervision, and
may offer other types of therapy. Their onsite medical staff sets them
apart from other types of senior housing. Nursing care is provided by
registered nurses (RN), licensed practical nurses (LPN), and nurses
aides at all hours of the day.

Standard Services:• clean, furnished room • housekeeping and linen service• medically planned meals & snacks • trained medical staff• professional service staff-activity director, social worker, etc.
Extra Charge: • on-call physician and physician services • physical, respiratory, and speech therapists • medications• personal care items • laundry service
Care • Basic Care - These are services required to maintain a resident's
activities of daily living. Basic Care includes personal care,
supervision and safety. A nurse aide, practical nurse or a family
member can provide this care. • Skilled Care - This is the level of care which requires the regular services of a registered nurse for treatments and procedures. Skilled
care also includes services provided by specially trained
professionals, such as physical and respiratory therapists. • Sub-Acute - This is comprehensive inpatient care designed for someone who has had an acute illness, injury, or chronic illness.
Subacute care is generally more intensive than traditional nursing
facility care and less than acute care, requiring frequent (daily to
weekly) recurrent patient assessment and review.

Regulation

Nursing Homes are licensed and regulated by State Departments of Public
Health and are individually certified by the State for Medicare and
Medicaid. They offer a staff of licensed and or /registered nurses,
nursing aides, and administrators as required by licensing standards.

The health care is supervised and authorized by a physician. They must
also meet federal requirements.

Payment Options

Nursing Homes charge a basic daily or monthly fee. Often families
purchase long-term care insurance in anticipation of the cost, while
others must depend on other forms of financing. Facilities accept a
variety of Medicare, Medicaid, private insurance carriers, and private
funds. The Nursing Home will ask you for financial information in order
to determine the appropriate payment source

Continuing Care Retirement Communities Services

Continuing Care Retirement Communities (CCRC) are residential campuses
that provide a continuum of care---from private units to assisted
living and then skilled nursing care, all in one location. CCRCs are
designed to offer active seniors an independent lifestyle from the
privacy of their own home, but also include the availability of
services in an assisted living environment and on-site intermediate or
skilled nursing care if necessary.

CCRCs offer a variety of residential services including the following:
• a maintained apartment, townhouse, or other unit • cleaning and laundry service • meals in common dining areas (# per day varies) • ground maintenance • security • social, recreational, and cultural programs

Health care services: • care is covered for contracted services • personal care and help with daily activities • nursing care • rehabilitative care • respite & hospice care • Alzheimer's & special care clean, furnished room

Payment

With Continuing Care there are many different types of contracts and
fees to consider. An Extensive contract offers unlimited long-term
nursing care for little or no increase in monthly fees. A Modified
contract includes a specified amount of health care beyond which
additional fees are incurred. Some communities may require residents to
purchase long term care insurance as criteria for acceptance. There are
also communities that provide services and access to medical care on a
month-to-month basis.

Cost

Monthly fees generally cover the following: • Meals (numbers may vary) • Scheduled transportation • House-keeping services • Unit maintenance • Laundry • Health monitoring services • Some utilities • Organized social activities • Emergency call monitoring • Security

Regulation

CCRCs are highly regulated in some states, but not in others. There is
no federal agency which oversees them. The Continuing Care
Accreditation Commission (CCAC), a private nonprofit organization,
accredits these communities. This voluntary process involves a review
of finances, governance and administration; resident health and
wellness, and resident life.

Alzheimer's/Dementia Care Services

Although many Assisted Living communities and Nursing Homes cater to
individuals with Alzheimer's disease and other related memory disorders
or dementia, there is a growing trend towards facilities that provide
specialized care and housing tailored to the special needs of
individuals with this disease. These facilities offer care that fosters
residents' individual skills and interests in an environment that helps
to diminish confusion and agitation. Specialty services are provided in
a secure environment, such as activity programs designed to include
reality orientation classes and specially trained professional staff
skilled in handling the behavior associated with memory impairments. Many facilities that specialize in Alzheimer's or related dementia
disorders have building design features that assist with the problems
associated with this disease: color-coded hallways, visual cues, and
secure wandering paths for additional security.

Care

Similar to Assisted Living communities, most provide assistance with
dressing, grooming, bathing, and other daily activities. Assistance
with medications differs according to state regulations. Meals, laundry
and housekeeping are usually provided within private and semi-private
rooms in a residential type setting.


Evaluate Your Needs

The following screening tool can help you determine which type of
housing or care is best for you or your loved one. For each category
below, please select the description that best describes your candidate
for senior care. Check only one choice per category. When finished, hit
the "submit" button, and the next page will display your results.

1. MOBILITY Capable of moving about independently. Able to seek and follow
directions. Able to evacuate independently in case of emergency. (1point) Ambulatory with cane or walker. Independent with wheelchair but needs
help in emergency. (2 points) Requires occasional assistance to move about, but usually
independent. (3 points) Mobile, but may require assistance due to confusion, poor vision,
weakness or poor motivation. (4 points) May require assistance when transferring from bed, chair or toilet.
(5 points) Requires transfer and transport assistance. Requires turning in bed
and in wheelchair. (6 points)

2. NUTRITION
Able to prepare own meals. Eats meals without assistance. (1 point) Can do some meal preparation, but needs main meal prepared daily. (3
points) Needs all meals prepared and served. (4 points) May require assistance getting to meals and or assistance when
eating, such as opening cartons or cutting food. (5 points) May be mostly or totally dependent on others for nourishment
(includes reminders to eat and/or assistance when eating). (6 points)

3. HYGIENE Independent in all care including bathing, shaving, dressing. (1
point) May require assistance with bathing or hygiene or may require
reminders or initiation assistance. (4 points) Dependent on others for most or all personal hygiene tasks. (6
points)

4. HOUSEKEEPING Independent in performing housekeeping functions (including
bedmaking, vacuuming, cleaning and laundry). (1 point) May need assistance with heavy housekeeping, vacuuming, laundry,
changing linens. (2 points) Needs laundry and housekeeping services provided. (3 points)

5. DRESSING Independent and dresses appropriately. (1 point) May require assistance with shoelaces, zippers, medical appliances or
garments, or may require reminders, motivation or initiation
assistance. (4 points) Dependent on others for dressing. (5 points)

6. TOILETING Independent and completely continent. (1 point) May have incontinence, a colostomy or catheter but is independent in
caring for self through proper use of supplies. (2 points) May have occasional problems with incontinence, colostomy or catheter
care, or may require assistance in caring for self through proper use
of supplies. (4 points) May be unwilling or unable to manage own incontinence through proper
use of supplies or may require physical assistance with toileting on a
regular basis. (5 points) Regularly and uncontrollably incontinent, dependent or unable to
communicate needs. (6 points)

7. MEDICATIONS Responsible for self-administration of medications. (1 point) Able to self-administer medications, but others may need to remind
and monitor the actual process. (3 points) Family or home health agency has arranged a medication administration
system with reminders and monitoring by family members or others. (4
points) Cannot administer own medications, even with supervision. Medications
must be administered by licensed personnel. (6 points)

8. MENTAL STATUS Oriented to person, place and time. Memory is intact but may have
occasional forgetfulness with no pattern of memory loss. Able to
reason, plan and organize daily events. Has mental capacity to identify
environmental needs and meet them. (1 point) May require occasional direction or guidance in getting from place to
place, or may have difficulty with occasional confusion that may result
in anxiety, social withdrawal or depression. Orientation to time, place
or person may be minimally impaired. (3 points) Judgment may be poor. May not attempt tasks that are not within
capabilities. May require strong orientation assistance and reminders.
(5 points) Disoriented to time, place and person, or memory is severely
impaired. Usually unable to follow directions. (6 points)

9. BEHAVIORAL STATUS Deals appropriately with emotions and uses available resources to
cope with inner stress. Deals appropriately with others. (1 point) May require periodic intervention from others to facilitate
expression of feelings in order to cope with inner stress. May require
periodic intervention from others to resolve conflicts and cope with
stress. (3 points) May require regular intervention from others to facilitate expression
of feelings and to deal with periodic outbursts of anxiety or
agitation. (5 points) Maximum intervention is required to manage behavior. May pose
physical danger to self or others, or is abusive or unacceptably
uncooperative. (6 points)
Payment Options

There are various ways of paying for senior housing and long-term care;
some of the most frequently accessed sources are summarized here.Private Funds Medicaid Medicare Long-Term Care Insurance Supplemental Security Income (SSI)
Private Funds Most people pay for independent living, assisted living, and CCRCs out
of their own pockets with private funds. There are some states which
accept Medicaid for assisted living, but there is currently no program
on the federal level, and private funds still account for approximately
90 percent of assisted living payments. About one-third of long-term
care at nursing facilities is paid with private funds. Back to Top
Medicaid What is Medicaid?As defined in Title XIX of the Social Security Act, Medicaid is a joint Federal-State program which pays for medical services to eligible needy
and vulnerable families and individuals. The State must offer basic
services in order to receive Federal matching funds, and the Medicaid
program varies from State to State.

Qualifications for MedicaidMedicaid is intended to pay for health and long-term care for persons
with limited financial resources. Common services include, but are not
limited to:
outpatient hospital services inpatient hospital services nursing facility services for persons aged 21 or older prenatal care physician services medical and surgical dental services home health and community-based care for persons eligible for nursing
facility services laboratory and x-ray services nurse-midwife services pediatric and family nurse practitioner services family planning services and supplies Payment for Medicaid ServicesMedicaid is a vendor payment program, and States may pay for Medicaid
services through HMOs or directly to providers.

The Medicaid payment
rates must be accepted as full payment in full. States may elect to
impose deductibles, coinsurance, or co-payments on Medicaid recipients
for some services. Medicaid and Nursing Home CareMedicaid currently pays for 60% of nursing facility care.

Medicaid and Assisted Living / Home and Community-Based ServicesMedicaid pays for only about 10 percent of assisted living services,
the majority being paid for with private funds. Several states have
adopted Medicaid waiver programs to earmark funds towards assisted
living, and this trend is expected to continue as cost containment
remains a critical issue for both State and Federal governments.

Medicare What is Medicare?As defined in Title XVIII of the Social Security Act, Medicare ("Health
Insurance for the Aged and Disabled") is a Federal health insurance
program for aged (65+) and certain disabled individuals (e.g., persons
with end-stage renal disease (ESRD) who require dialysis or a kidney
transplant), regardless of income. Medicare is comprised of two parts, defined as follows:

Part A (Hospital Insurance): Provided automatically to individuals 65
and over who are entitled to Social Security, and to disabled persons
who have received such benefits for at least 24 months. The health
services covered under Part A are: Skilled Nursing Facility (SNF) Care: Covered by Part A only if it follows within 30 days of a hospitalization of three or more days, and
is certified as medically necessary. Medicare does generally not pay
for long-term care in a nursing facility, and the number of SNF days
provided for is limited to 100 days, with a co-payment required for
days 21 to 100. Home Health Agency Care: Can be furnished by a home health agency at
the residence of the beneficiary. Part A may also pay for some medical
equipment and medical supplies. Hospice Care: Provided to terminally ill individuals who have a life
expectancy of six months or less, and who choose to forgo standard
medical treatment. Inpatient Hospital Care: Includes coverage of the costs for most
hospital services, including operating room, intensive care, laboratory
tests, inpatient prescription drugs, X-rays, rehabilitation, long-term
hospitalization,, meals, and semi-private room. Part B (Supplementary Medical Insurance): Provided to almost all U.S.
residents 65 or older, certain aliens 65 or over, and disabled
individuals entitled to Part A.

Part B coverage requires payment of a
monthly premium, and primarily covers physician services. Also covered
by Part B are non-physician services, including diagnostic tests,
ambulance services, clinical laboratory tests, flu vaccinations, and
some therapy services.

Long-Term Care Insurance What is Long-Term Care Insurance?Long-term care insurance covers the cost of long-term care in certain
types of care facilities, depending upon the policy. Policies may cover
stay in licensed nursing facilities and home health care. Often, those
persons with a sizable asset base may wish to purchase a policy to
protect these assets. Where can Long-Term Care Insurance be Purchased?Long-term care policies are sold by private insurance companies (not
all insurance firms offer this type), through agents, mail, and various
organizations. Another source is employers, who offer this coverage as
a benefit to employees and their parents. An insurance company must be
licensed in your state to sell long-term care insurance.

How Much do Policies Cost?Premiums for Long-Term Care Insurance are based on the age of the
person at the time of purchase, the benefit amount, the benefit time
period, elimination or deductible, and special options (i.e. inflation
adjustment, non-forfeiture benefits and spousal discounts).
Back to Top
Supplemental Security Income (SSI) SSI is a monthly cash payment from the government for eligible
individuals in financial need who are aged 65 or older or persons who
are blind or have a disability (including children). Typically, a
person eligible for SSI payments has no or little income, total assets
of less than a few thousand dollars (within certain limits set out in
regulations, not including a home used for self support, automobile,
values of household goods, personal effects, and life insurance), has
U.S. citizenship or qualified alien status, and U.S. residency. In certain circumstances, the SSI payment may be used towards some
housing and care needs of the individual.

The SSI program is run by the Social Security Administration
(http://www.ssa.gov/), but the SSI is not the same as Social Security. Money
for SSI payments comes from the general fund of the U.S. Treasury, and
some states add money to the federal payment.


WE VALUE OUR SENIORS! OUR PAST HELPS US WITH UNDERSTANDING THE FUTURE!

TAKE THE TIME TO INTERVIEW( or just a plain old conversation) OUR SENIORS, IT WILL MAKE FOR SOME VERY INTERESTING CONVERSATION, ADVICE, AND INFORMATION.

Keep those tape recorders, and Video Camera handy! Don't miss a history, or family story.

MAKE SURE YOU ARE IN THE LOOP!!

COULD YOU SURVIVE TWO WEEKS?


When considering a Nursing home, or Assisted living facility, for a loved one, make sure you
know what the conditions, and atmosphere is like.

Could you survive two weeks in the same facility"

Read on. I hope these Easy Insurance Helpful Tips might give some direction for you and your loved one.

ELDERS and CAREGIVERS
What Caregivers need to know about
AOA - Administration On Aging
There are numerous products and resources that have been developed through the Alzheimer's Demonstration Program. Some resources are designed for caregivers and families, while others were designed for physicians and service providers. Please feel free to browse through all of the available resources and to contact the individuals listed to obtain copies
Alzheimers Disease and Related Dementia
Alzheimer’s and related dementia, and the debilitating effects of other chronic diseases, are primary causes of the rapid increase in demand for long term care services. Perhaps more than any other disabling condition, Alzheimer’s Disease affects the quality of life of family caregivers.

The prevalence of dementia and its widespread impact is a leading cause for public advocacy to increase federal support of basic research on its causes, and through states and voluntary agencies, home, community and residential services.
Center for Communication and Consumer ServicesU.S. Administration on AgingTel. 202-619-0724FAX 202-357-3523Internet: http://www.aoa.govEmail [aoainfo@aoa.gov]

Additional Topics Caregiving Issues Caregiving Resources AoA's Alzheimer's Program Promoting Healthy Lifestyles Eldercare Locator
Clergy

You are One of Us: Successful Clergy / Church Connections to Alzheimer's Families
DescriptionA booklet for churches and clergy which explains Alzheimer's disease, how to communicate with those who have it, and how it affects families. Also a guide for and quot;tending to the spiritual self and quot; and ways one can reach out to those with Alzheimer's disease and their families.
Created: 1995Format: HandbookPurpose: Outreach materialsTargeted Cultural Group: GeneralAuthor/Producer: Lisa P. Gwyther, MSW; Duke University, Center for Aging, Alzheimer's Family Support ProgramComment:Contact Source: Duke University Medical CenterPhone numbers: (919) 684-8111Audience: Families, clergy, volunteers, and service providersReference #: 42

Family & Caregivers
Caregiving at Home

DescriptionA brochure in Chinese translated from the English version of the same name provided by the Alzheimer's Association of Western and Central Washington. The text has been revised and adapted into Chinese to be linguistically and culturally appropriate. The brochure provides important information to care providers who take care of the elderly person at home.Created: 1996Format: BrochurePurpose: OutreachTargeted Cultural Group: ChineseAuthor/Producer: Alzheimer's Association - English versionComment:Contact Source: Chinese Information and Service CenterPhone Numbers: (206) 624-5633Audience: Families, health professionals, and general public

General Public

Ethnic Communities and Dementia: Making a Difference
DescriptionThis 20-minute educational video and accompanying brochure illustrates the development of four programs developed through a seven-year Alzheimer's Demonstration Program to serve caregivers from different ethnic populations including Chinese, Latino, Korean and Native Americans.
Created:Format: VideoPurpose: TrainingTargeted Cultural Group: Aging network, ethnic communities and Alzheimer's Association chaptersAuthor/Producer: Aging and Adult Services Administration/Department of Social and Health Services/Washington StateComment: Cost: FreeContact Source: Local Alzheimer's Chapters, state units on aging or Aging and Adult Services/WashingtonPhone numbers: (360) 725-2545Audience: Program planners, service providers, heath professionals
Support Groups

A Family in Crisis: Legal Responses and Alternatives
DescriptionA 90-minute video of an interactive teleconference. The format presents a son, "Ben", who assumes responsibility for his father's dementia, his mother's frailty, and a younger brother with developmental disabilities. Attorneys from the Montana Office on Aging and the Montana Advocacy Program respond to Ben's situation. Various legal options are presented including conservator, power of attorney, and legal guardianship.
Created: March 1996Format: VideoPurpose: Specialized educationTargeted Cultural Group: GeneralAuthor/Producer: Montana Office on Aging, Ann O. Johnson, Ed.D., Executive Producer, Montana Alzheimer's Demonstration Project, The Montana Office on Aging, and the Montana Advocacy ProgramComment:Contact Source: Ann JohnsonPhone numbers: (406) 582-1492Audience: Families, general public, service providers, caregivers, and support groupsReference #: 43

Web Links
Alzheimer’s and related dementia are primary causes of the rapid increase in demand for long term care services. Perhaps more than any other disabling condition, Alzheimer’s Disease affects the quality of life of family caregivers. The links provided below are designed to help families and professionals alike in their effort to care for persons with Alzheimer’s disease.
*These links will take you to sites outside of the Alzheimer's Demo Web Site.
Internet Based Resources on Alzheimer's Disease:http://www.aoa.gov/naic/Notes/alzheimerdisease.html
National Aging Information Center:http://www.aoa.gov/naic/

Promoting Healthy Lifestyles
“We are encouraging Americans of all ages to live healthier lives. Healthy living can prevent diseases and certain disabilities, and it can ensure that today’s older persons – as well as future generations – not only live longer, but also better.”
-Josefina G. Carbonell

Great improvements in medicine, public health, science, and technology have enabled today’s older Americans to live longer and healthier lives than previous generations. Older adults want to remain healthy and independent at home in their communities. Society wants to minimize the health care and economic costs associated with an increasing older population. The science of aging indicates that chronic disease and disability are not inevitable. As a result, health promotion and disease prevention activities and programs are an increasing priority for older adults, their families, and the health care system.
Many Americans fail to make the connection between undertaking healthy behaviors today and the impact of these choices later in life. Studies by the National Institute of Aging indicate that healthy eating, physical activity, mental stimulation, not smoking, active social engagement, moderate use of alcohol, maintaining a safe environment, social support, and regular health care are important in maintaining health and independence.

Promoting the healthy lifestyles of older people is vital in helping them to maintain health and functional independence and lead healthy and independent lives. Providing information to you about disease prevention and health promotion activities will help us help you and your loved ones become more knowledgeable about the health problems you may face and how you can prevent, delay, or manage them. We are using the Department’s report called Healthy People as a framework for providing you with this information.

The report, originally published in 1979 and updated throughout the past thirty years, identifies the most significant preventable threats to health and focuses public and private sector efforts to address those threats. The overarching goals of the most recent update of the report, Healthy People 2010, include increasing the quality and years of healthy life and eliminating health disparities. Within the report there are twenty-eight focus areas with goals and objectives within each area.

The areas listed below are ones that we have chosen that relate to the Department’s objectives and the health of older Americans. The list below contains links to information that we feel you and your loved ones need to be informed of in order to lead healthy lives. We provide additional resources within each area that we feel will be helpful to you. Please use the general health resources below to access detailed health information on a variety of topics.
Promoting Healthy Lifestyles Sub Navigation:

Arthritis and Osteoporosis

Asthma

Cancer

Diabetes

Disabilities

Health Screenings

Heart Disease and Stroke

Physical Activity and Nutrition

Mental Health

Overweight and Obesity

Vaccine Related Immunizations

I hope these Easy Insurance Helpful Tips have really helped, or given some direction.

DON'T LET YOUR LOVED ONES SUFFER!

OUR ELDERS

If you love them, and care about their comfort, don't let any of this happen to them, if they must stay in a nursing home, or assisted living facility!

Easyinsurance Helpful Tips suggest you check with your health insurance carrier before you make your final decision when choosing a resident friendly care facility.

Your health insurance carrier may be very helpful, because of their knowledge of which insurance loss prevention programs reputable Nursing home , and assisted living facilities, participate.

Nursing Home Facilities

Abuse and Neglect

Assessing Nursing Home Facilities
overview assessment tips other facilities

It is vital for your family member that you spend a considerable amount of time researching the nursing home before you send them to one. Do not judge the nursing home on the basis of a guided tour or the nice furniture or attractive physical features of the facility.

Visit with residents

You should find at least one resident that you can visit in the facility. This will help you in evaluating the facility without a guided tour. Walk up and down the halls and talk to bedridden residents and those who are wheelchair bound. As you talk to them, check out their grooming, skin quality, nail care and oral care. See if the residents appear upbeat or if they are depressed. If almost everyone you talk to is confused and unable to have a normal conversation, this could be cause for concern.

Assisted living facilities

Assisted living offers a wide range of services with a wide range of monthly fees. If you need assistance getting through the day, but don't require the intensive supervision and medical services of a nursing home, assisted living may be for you or your loved one. Take the time and investigate state agencies which may assist with payment for assisted living facilities.

Services, staffing, and philosophy of this type of housing vary enormously. It is very important that you determine exactly what is offered in each home. Look for a place that encourages residents to be active. People who have been loners all their lives are unlikely to adapt well to congregate living, and a mentally alert person doesn't belong in a small home with cognitively impaired people. Make sure the person is suited to assisted living.

If you disagree with certain provisions in the admission contract, see if you can modify or eliminate them. Contracts should allow for a minimum of 30 days notice if the facility desires to end the agreement. You should know who makes the decision regarding transfers when a resident's health declines. Remember, assisted living facilities are not immune from the same problems facing nursing homes, particularly the difficulty of keeping a stable staff.

Medical Issues in Nursing Homes
Overview

Nursing home patients may find themselves subject to dozens of adverse conditions through no fault of their own - bed injuries, pressure ulcers, falls, fractures, malnutrition and dehydration are some of the more prominent injuries.

Debilitating conditions that can occur in nursing homes.

Bed injuries

Between 1993 and 1996, there were 74 reports of death from strangulation or suffocation involving hospital beds. The federal General Accounting Office has concluded that many deaths go unreported.

Some siderails extend the full length of the bed; others, called half rails, are about 2-1/2 feet long. Some are metal, others plastic. Most can be raised or lowered.
Siderails are divided, either vertically or horizontally, with slats spaced about six or more inches apart. This space can trap an elderly person's head, causing him or her to strangle; or, to allow a thin, frail person to squeeze between the rails and fall to the floor.

Often mattresses fit loosely in the frame, leaving gaps large enough to trap the resident between the mattress and siderail, also leading to suffocation.

Falls and fractures

Falls are the most frequent causes of fractures in the elderly. Nursing home residents are at increased risk for falls primarily due to advanced age of the population. There are many other factors which place individuals at risk for falls. Nursing home personnel are regularly required to assess patients to determine their risk for falling, and provide safety devices and services to minimize the risk of injury to the resident. Some of the risk factors for falls include:

Previous falls
Cardiac arrhythmias
Stroke
Central nervous system disorders such as Alzheimer's disease, Parkinson's disease, dementia and others

Problems with mobility and gait
Low blood pressure (orthostatic hypotension) on standing up
Bowel or bladder incontinence
Dizziness
Dehydration
Visual impairment
Use of restraints
Medications

Dehydration

Dehydration should be managed through an individualized daily plan to promote adequate hydration based upon identifying the risk factors which include at least the following:
Alzheimer's, or other dementia Major psychiatric disorders Depression Stroke Repeated infections Diabetes Malnutrition Urinary incontinence History of dehydration 4 or more chronic conditions Use of diuretics, antidepressants, psychotropics, or anti-anxiety medications, laxatives, or steroids Chronic cognitive impairment Inadequate nutritional status Acute situations: vomiting, diarrhea and/or fevers

Malnutrition

Nutritional well-being is an important part of successful aging. Improper nutrition or malnutrition can lead to infections, confusion, and muscle weakness resulting in immobility and falls, pressure ulcers, pneumonia, and decreased immunity to bacteria and viruses. Malnutrition is costly, lowers the quality of nursing home residents' lives, and is often avoidable.
Based on the nutritional assessment, the facility must take steps to ensure that the resident maintains good nutritional health and must provide residents with a well-balanced, palatable meal.

Many things can cause malnutrition in nursing home residents. The following are factors that may prevent a resident from receiving adequate amounts of the vitamins, minerals, protein, and calories the resident needs:

Physical Causes: Illness Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness Food and drug interactions which decrease the ability of the body to absorb vitamins and minerals Depression Swallowing disorders Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain Tremors, which affect the residents' ability to feed themselves

Environmental Causes: Inadequate attention from staff for residents who need assistance eating Staff who are uneducated about malnutrition and proper ways to feed residents who need help Reliance on liquid supplements Special diets

Signs That A Resident is Malnourished:Ask the following questions to determine whether your loved one is demonstrating signs of malnutrition: Do clothes fit more loosely than usual? Are there cracks around the mouth? Do lips and mouth look pale? Has the resident complained that his/her dentures no longer fit? Has the resident's hair been thinning or growing more sparse? Do wounds seem to take longer to heal? Does the resident appear confused (not as a result of a disease such as Alzheimer's)? Is the resident's skin breaking down? Does the resident's eyes look sunken? Does the resident appear to be losing weight?

If the answer is yes to two or more of these questions, the following may help pinpoint specific problems: Can the resident feed him/herself? What is the resident's favorite meal of the day? When and where does the resident prefer to have meals served? Does it take a long time for the resident to eat? Is the resident rushed through meals? Is the resident unable to finish meals?

Does the resident seem to eat more when someone is there to help with the meal? Does the resident seem uninterested in food? Has the resident lost his/her appetite? Does the resident like the food at the facility? Can the resident choose from a menu? Are snacks readily available to the resident? Is the resident on a special diet? Has the resident started taking any new medications? Has the resident's weight routinely been monitored? Has the staff informed family members of weight loss? Has staff asked family members for assistance?

Do Your Homework, when choosing, or considering a Nursing Home, or a assisted living facility, for a loved one.