​​​Elder Care Services - Determining Your Level of Care

The condition of the person seeking nursing care is the key factor in your choice of a long-term care facility. All skilled/intermediate care nursing facilities provide personal care and residential services including rooms, meals, planned activities and programming to meet social and spiritual needs. The levels of nursing and therapy services offered vary quite widely, and these should be carefully matched to the individual’s needs. The resident’s physician is involved regularly in the direction of a resident’s care. The nursing staff works with and keeps the resident’s physician updated on any changes in the resident.
Sheltered Care
People, who are functionally independent but need some assistance in daily living, require the care of a sheltered care facility (SC).
Sheltered care facilities emphasize the social needs of the individual rather than the medical needs. Dietary and housekeeping services, medication monitoring, and leisure activities are primary functions of these facilities.

Assisted Living
People who are mobile but may need assistance with one or two activities of daily living, may require the services of an assisted living facility.
An assisted living facility is a congregate residential setting that provides or coordinates personal services, 24-hour supervision and (scheduled and unscheduled) assistance, activities, and health-related services; is designed to minimize the need to move; is designed to accommodate individual residents' changing needs and preferences; is designed to maximize residents' dignity, autonomy, privacy, independence, choice, and safety; and is designed to encourage family and community involvement.

Intermediate Care
People who need 24-hour nursing care by licensed nurses as prescribed by a physician, require the care of an intermediate care facility (ICF).
Rehabilitative programs, social services and daily activities for persons not capable of full independent living, (such as persons who are convalescing or persons with chronic conditions which are not critical) are provided. Physical, occupational and other therapies are also provided. This type of facility may be certified to participate in the Medicare and/or Medicaid program. Check with each facility.
Skilled Nursing Care

People who need 24-hour care require the care of a skilled nursing facility (SNF).

Registered Nurses (RN), Licensed Practical Nurses (LPN), and Certified Nurse Assistants (CNA) provide care and services prescribed by physicians with heavy emphasis on medical nursing care. Social services, as well as physical, occupational and other therapies are provided. This type of facility may be certified to participate in the Medicare and/or Medicaid program. Check with each facility.

By: Victoria Care Home 

How To Spot Elder Abuse

Elder abuse is described by the following acts among family and members of the household, any nursing home staff or any individual. 

- When somebody attempts or causes physical injury to an elder
- When the family member or staff of a nursing home try to or is trying to place an elder in terror or alarm of physical harm by torment, threat or harassment
- When one is convincing or persuading an elder by strength or intimidation to participate in a certain act from which the elder has the right to withhold
- When one meaningfully confines the movements of an elder without his consent
- Threatening the elder to a crime of violence

1. Detecting Abuse: 

- Burn markings from cigarette
- Black eye, lacerations, bruises or cuts that can not be explained
- Rope marks, a sign that the elder had been tied or slashed upon
- Hair loss, a sign that the elder's hair was pulled
- Bodily sores and wounds
- Fingernails that are broken
- The elder's skin is very poor condition
- Fractures of the bone
- Bite marks
- Eye glasses are broken
- Laboratory results are positive of drug overdose
- The elder displays a sudden change of behavior
- The care giver refuses to allow visitors to see the elder

2. Signs Of Neglect: 

- Sores are untreated
- Displays significant signs of malnutrition
- May show signs of insanity
- Lack of personal hygiene care

3. Signs Of Emotional Abuse: 

- May display a nervous behavior
- Constantly be disturbed or upset
- Displays a negative attitude
- Always in anxiety
- Demonstrate signs of insecurity, such as constant sucking or biting of the fingers

4. Financial Abuse: 

- Unknown withdrawal from the elder's account
- Unusual ATM withdrawals and switching of accounts
- The elder tend to withdraw money often
- The elder does not receive his pension or Social Security check from the mail
- The elder, without any valid reason, revises his will and changes his beneficiary
- The elder unexplainably signs contracts that results to unwanted financial commitment
- Signature was forged
- The elder has plenty of unpaid bill, despite his assets that can very well cover the bill
- Strange credit card charges

5. Signs Of Sexual Abuse

- Mysterious and unexplained genital infection
- Anal or vaginal bleeding that can not be explained
- Ripped underwear
- The elder may tell someone that she has been sexually abused
- Genitals are bruised
- The elder may report that her care giver is showing her pornographic materials
- The report of the elder that she is forced to touch someone's genitals, observe sexual acts, tell dirty stories and pose nude for a picture

6. How Can You Prevent Abuse To Yourself As An Elder?

- Keep and continue contacts with friends and neighbors
- Work out on a buddy system with other elders in the home
- Be active socially, do not be in isolation
- Protest and speak up if you are not happy or contented with the way your caregiver or other family member treats you. Tell somebody
- Request your friends and other relatives to visit you often
- Open your mail personally
- Never sign anything unless it was reviewed by someone that you trust
- Always review your will once in a while
- Coordinate so that your pension or Social Security check be deposited directly to your bank account than being sent by mail

7. How Can You Prevent Abuse To Others?

- Pay attention. Be wary and look out for signals that might point towards abuse
- Call your loved one as frequently as possible
- Visit your loved one often and make certain that she is well taken cared of
- Always be open to your loved one, taking the time to always talk to her and assure her that you are there to help and can be trusted
- Get permission to periodically look into your loved one's bank accounts as well as credit card statements for unauthorized withdrawals or transactions

8. How To Get Help If You Or Someone You Know Is Suffering Abuse:

911 or your local police emergency number or your local hospital emergency room

By: Victoria Care Home 


Victoria's Care Home 

    559-960-3789      559-419-5000

​     Fresno – California  

Massage Therapy for Senior Citizens

Massage therapy can offer senior citizens a number of benefits that will greatly improve their sense of health and wellbeing.  As the population continues to age, it is important to consider ways that we can work to improve the lives of those affected by the passing of time.  A number of studies have shown that massage therapy can have a direct impact in managing the effects of aging.  It has also shown promise in bringing comfort to those suffering from arthritis and other physical ailments.

As people age, they naturally become less active.  This lack of physical activity can lead to the onset of other conditions which, if not dealt with, can greatly reduce their quality of life.  The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) has been promoting the use of massage therapy for some time now.  According to a recent study, there is a general awareness of massage therapy but a lack of understanding of its direct benefits.  

In the case of senior citizens, there are a number of benefits that be derived from therapeutic massage.  According to the Touch Research Institute, it is extremely useful in the treatment of Alzheimer's patients, as it can facilitate relaxation and communication.  In the case of arthritis sufferers, it can greatly assist in pain management and help increase range of motion.  It also triggers natural joint lubrication, which is extremely important for those suffering from arthritis.  

Massage therapy has also shown promise by helping to increase strength and muscle coordination.  It can also greatly improve one's posture by reducing muscle tension, which has the added benefit of assisting seniors with a higher quality of rest.  Massage has also been known to boost one's natural energy levels, along with their mental awareness.  Study after study has shown that there is a place for massage therapy within the health care community.  

More and more people are becoming aware of the benefits of massage therapy.  In an age where the common approach to pain management has been dominated by the interests of the pharmaceutical industry, massage therapy has shown to be an effective and natural solution to the ailments associated with process of aging.  If you or a loved one are interested in learning more about the benefits of therapeutic massage, please visit the website mentioned below.

By: Victoria Care Home 

How Does Assisted Living Work
Assisted living facilities are meant for senior citizens and the disabled who require housing, and assistance with activities of daily living (ADLs) such as bathing, dressing, and assistance with taking medicine. These facilities enable people to follow an independent lifestyle and at the same time provide the right type of assistance needed in day-to-day activities. Occupants of assisted living facilities are generally unable to live independently but are also not in need of full-time care. Thus, an assisted living facility offers an alternative to nursing homes that are more suitable for senior citizens with a greater need for care. 

Assisted living facilities are sometimes referred to as residential care, personal care, adult congregate living care, domiciliary care, retirement residences, adult homes, etc. Assisted living facilities often operate in conjunction with nursing homes and independent living residences. Together, the three constitute Continuing Care Retirement Communities. Thus, an individual can start by shifting into an independent living residence and move on to assisted living facilities or a nursing home depending upon his requirements as he ages. 

Housing facilities can be private single rooms or private suites. Assisted living residences often have ensuite bathrooms and common dining facilities. The occupant and housing facility are expected to enter into a written occupancy agreement. Assisted living facilities can provide housekeeping, meal services, laundry, and round-the-clock emergency services. 

The personal assistance provided at assisted living facilities ensure that the dignity and self-respect of the occupants are upheld and that they get ample opportunities to socialize, make friends, and also keep in touch with their family. The assistance can be either routine or intensive. The personal assistants are trained to be mindful of the requirements and values of senior citizen. They usually hold a college home support/resident care aide certificate or have the required balance of experience and learning. Personal assistants may operate under the supervision of professionals such as registered nurses. 

The key points to be borne in mind while selecting an assisted living facility should include :

– Atmosphere – This would include the size of the facility, visiting hours, opportunities for socialization, and meal-related information. 
– Activities – Factors such as flexibility of schedule, presence of lounge areas, and chance of interacting with neighboring communities should be considered.
– Amenities – Presence of exercise facilities, availability of equipment for supporting patients with special needs, religious facilities, and storage space are the amenities that should be present.
– Costs – Costs of staying at the facility, rate at which expenses fluctuate, as well as services and utilities included in the costs are some of the features that should be considered while checking out the costs.

A facility should be visited and the opinions of staff and residents should be taken into consideration. In order to get a complete picture, the facility should be visited on multiple occasions at different times of the day over a period of time.

By: Victoria Care Home 

Sleeping Problems in the Elderly

Sleeping problems in the elderly are more than likely to manifest in a particular pattern, depending on the health of the person, and the prescription drugs they may be taking for their health problems.The quality of their sleep may change considerably, either because of less demands on their energy as a result of retirement, or through illness.

Illness disrupts sleep patters in the elderly, and may result in increased awakenings due to physical discomfort.Urinary urgency, cramps, angina,chronic obstructive airways disease,and left ventricular failure may be some of the many illnesses which cause sleep problems in the elderly.

An elderly person may become very anxious about a change in their sleep pattern, however, it will be necessary to thoroughly investigate the problem in order to ascertain if this perceived sleeping problem, causes dysfunction in their waking activities.If the elderly person has a carer, or lives with family then the problem may be easier to assess, for what appears to be a problem may only be a normal change in sleep pattern for the age.

The most frequently occurring sleep problem in the elderly  appears to be sleep latency, the person may spend some hours in bed before sleep occurs. This may be perceived by the elderly person to be a problem, and sleeping pills may be sought.Sleep latency is more common in females, and this appears to apply in all age groups, not just to elderly persons,however, it does occur more often in elderly females. 

Possibly reduced daytime activity,combined with daytime naps may contribute to reduced quality of sleep in the elderly. The pressure of a normal working day has been taken away, so the energy output is considerably less, while this may be offered as a possible reason for sleep latency, many others factors may be involved.

There may be much confusion about sleep latency, the difficulty may be exaggerated because the person who experiences it may be convinced that unless they have 8 hours of quality sleep, they will become ill.Sometimes it is difficult to convince an elderly person that they no longer require 8 hours of unbroken sleep, but may be better served by a shorter night time sleep supplemented with day time naps.        

Re the old remedy of a glass of milk before bed:
According to Jean Carper, The Food Pharmacy, milk for insomniacs,never!
Milk, particularly low fat milk wakes you up. " Milk deliver tyrosine to the brain, which in turn triggers production of dopamine and norepinephrine, stimulating you to think more quickly, and accurately".

So how can sleep problems in the elderly be resolved?  Firstly, a warm comfortable noise free environment, regular exercise, good diet, no heavy meals at night, no eating late at night,  relaxation therapies, aromatherapy, herbs like valerian may be taken as a tea, provided that your doctor has been consulted. Homeopathy is the cheapest, the least invasive, the most gentle, with no side effects, and no interactions with any drugs you may be taking. No homeopathic remedies are recommended here for it is important to consult a qualified homeopath in order to achieve the best outcome for the patient.

Sleep problems in the elderly should be thoroughly investigated before any medications are prescribed. Unfortunately this is not always the procedure that is adopted, for often a script is written for what has been described as insomnia by the elderly person, however, such is mostly not the case, but rather it's a normal progression of a resetting of the circadian rhythms which requires education, not medication.

Provided that there is no evidence of disease of the central nervous system, such as dementia, Parkinson's disease, post-traumatic brain damage , and chronic pain, then sleep problems in the elderly are far better managed conservatively.

By: Victoria Care Home 

Assisted living vs nursing home care

Often times the terms "assisted living" and "nursing homes" are used interchangeably.  This, however, is a mistake because the two are actually very different.  A person who is a candidate for one facility will not necessarily be a candidate for the other.

While in-home care for aging seniors can be more cost-effective, those that require extensive caregiving time will find that a nursing home or assisted living facility will be more cost-effective than attempting to create a nursing facility in the home.  Despite the expense, however, most seniors would prefer to stay at home for as long as possible.

The term 'assisted living' allows the senior adult their own living space but provides a level of monitoring that most people can not afford in their own home.  The key benefit is that services are already in place if the individual's health continues to deteriorate.  Most facilities allow residents to start with the basic apartment and live independently with additional services such as cleaning, meal preparation or transportation if needed.  When additional assistance becomes necessary, such as dressing, bathing or walking, help is available on site.

The average cost for an assisted living facility in California hovers around $4000 per month according to a 2017 survey.  In some states some of the assisted living services are covered under Medicaid, but most people pay for them through long-term care insurance policies or out-of-pocket.

Nursing home care is often the last step for individuals who require constant round-the-clock monitoring and medical care.  If an individual's health has deteriorated to the point where that much care is required at home it is no longer financially efficient to provide it.  Annual costs for nursing homes can range from $65,000 to nearly $250,000 a year.

Although those costs are high, the cost of a home health aide 24 hours a day will range close to the same price.  Costs on top of the home health aide will include room and board for the aid, covering shifts, housing and gas and electric, all of which are covered under the cost of the nursing home.  Once an individual's assets have been exhausted Medicaid will pay for most nursing home care that accepts the plan.

In the past, families attempted to give away their parents assets a month or two before moving into a facility.  However, current federal law now requires a five-year look back period to prevent this type of activity from happening.

When choosing either an assisted living facility or a nursing home evaluate the care that given and the facility itself to ensure that your loved one receives the best care possible.  Talk to residents and their families and evaluate the facility with your nose.  That means if it doesn't smell good you can probably be as sure that seniors are not as clean and the facility is not as well run as it should be.

Find out about the staff to resident ratio.  While the published number may be one thing the reality may be another, because nursing homes are chronically understaffed.  Ask the nurse's aide on shift and find out how many nurses there usually are staffed on the unit.  One registered nurse for every 15 residents is the national average but in many facilities often go above that number.

Pay attention to the details in the facility.  Is it clean?  Is the piano tuned? Are in the cosmetics (wall paper, paint, furniture) clean and well cared for? If the staff takes care of small things they probably also take care of the big ones.

It's also important to remember that the care given to individuals in nursing homes and the assistance given to those at assisted care facilities is often the best when loved ones are present, visible and stay involved.

By: Victoria Care Home 

Living will for seniors

A living will is the legal document that expresses your opinion and provides directives for your medical care in a situation in which you are unable to express them yourself.   It is the best way to manage healthcare when you are unable to make those decisions yourself.

Asking if you have a living will currently active is one of the current questions being asked of individuals when they are being admitted into the hospital.  This does not just include seniors, who may be more likely to experience a physically incapacitating events, but also all individuals who are over the age of 18 and no longer under the legal care of their parents.

But, because seniors have a higher likelihood of suffering an incapacitating event which will render them unable to express their desires for their medical care, it is important for them to have designed a living will to speak in their place.  A living will takes the guesswork out of your healthcare for your family, your loved ones and your physicians and help them to know exactly what it is that you would like to have done for yourself.

The simplest, and yet the most expensive, thing to do is to choose a lawyer and have them create the living will.  The cost can run around several hundreds of dollars depending upon the area of the country in which you live and the attorney you hire.  Another way to accomplish this task is to use an online creation software program.  You will be asked to answer many questions after which the staff will check the document and mail it to you for signatures.  The typical cost for this is approximately $50.

And the most cost-effective way is to use a fillable form that you download from the Internet or ask to get from a charitable organization.  Many office supply stores also supply them and are available from the state government, hospitals and hospices.

Which ever form you choose to take there are questions that you must answer before filling out your form.  Healthcare options will be included in the living will, also called an advanced directive, that will include orders for feeding tubes, oxygen supplies and "do not resuscitate" orders.  You may want to discuss these options with your family physician, family members or close personal friends.

Most advanced directives will cover issues about cardiac resuscitation, mechanical ventilation, antibiotics, artificial nutrition, artificial hydration, pain medication and do not resuscitate orders.  It's important that individuals think clearly about how they feel about these issues prior to signing their advanced directive.

A living will can be made as specific as the individual would like regarding these situations.  You should be very specific about how you feel about artificial nutrition, hydration and cardiac resuscitation since states differ in their laws.  "Comfort measures" can include anything to make the end of your life easier that will not prolong your life such as pain medication and oxygen therapy.

A living will gives direction to physicians and family about your medical care but a durable power of attorney for health care will give that power to a specific individual and take it out of your hands completely.  This document will allow you to a plan a proxy, or agent, to make medical decisions when you are incapable of communicating them.  Most of the time these decisions will not be easy ones and can include things such as withholding artificial nutrition or hydration or issuing a do not resuscitate order.

A living will addresses the desires of the patients under dire circumstances while a durable power of attorney will allow an individual to make other types of health care and treatment decisions if you are deemed incompetent.

Before doing anything remember to think deeply about your feelings and what they mean to you and decide on the specifics of what you want to address.  If you want comfort measures placed into your living will then specify which ones you'd like and not like and if you want to prepare a durable power of attorney choose a person who is close to you that can help make your medical decisions if you cannot.  It might be in your best interest to choose to individuals to serve in the capacity is your healthcare agent if one is unable to make it to the hospital and enough time.

Once you have a living will and durable power of attorney it's important to distribute those to your primary care physician and family members who may be present at the time of an accident or if circumstances are beyond your control.  If you are being admitted into the hospital it is also wise to bring a copy with you so the hospital has one on file and can rely on that should anything happen.

By: Victoria Care Home 

Nutrition For The Elderly

Healthy eating and nutrition for the elderly is greatly impacted by several factors, one of them being a change in body composition.  During the later years in life, the body will lose bone and muscle and gain fat because the hormones aren't very active anymore. There are many factors, which hinder an elderly person's health.  The information below will help you to lead a healthy life - no matter how old you may be.

Water in the body decreases with age, so many older folks will become dehydrated very easily.  Sometimes they won't feel thirsty, while other times it's too much work to pour a glass a water.  With this in mind, it's recommended that they drink at least 1 ounce of water for every 2.2 pounds of weight.

At this stage in life, protein is very important. Protein is needed to support a healthy immune system and prevent the wasting of muscle.  Since energy needs are less, older folks should eat high quality protein such as eggs, lean meats, poultry, and fish.

Carbs and fiber

Carbohydrates are the main source of energy for the entire body.  You can find carbs in bread, cereals, pasta, and other grain products.  A diet that's high in fiber and water will help to prevent constipation as well.

Fat intake for the elderly should be limited, not eliminated.  You can limit fat by choosing lean meats, low fat dairy products, and food preparation methods that don't include frying. 

For the elderly, iron deficiency can be seen with those who aren't eating much.  Good sources for iron include lean red meats or breakfast cereals.

Zinc intake is normally with the elderly, and to make matters worse, it's not absorbed very well either.  Meat, poultry, and fish should be a part of your diet to help you meet the requirements for zinc.


Calcium is one ingredient that most elderly folks simply aren't getting enough of.  Most believe that milk upsets their stomach, and therefore they will avoid it.  They should be getting around 1,500 mg of calcium a day, and nonfat powdered milk can be used in recipes as a substitute for milk.  Other foods such as yogurt, low fat cheese, and broccoli can also help you meet the requirements for calcium.

Vitamin B12
In order to absorb the benefits of B12, the intrinsic factor must be produced by the stomach.  Most elderly people suffer from a deficiency in B12 because they have a condition known as atrophic gastritis.  This condition causes inflammation of the stomach, bacterial overgrowth, and the intrinsic factor. Without the intrinsic factor, this vitamin can be absorbed.
Each one of the above nutrients are needed to keep an aged body in good health.  Elderly individuals should try to stay active and strive for a well balanced diet.  Even though the aged body isn't the same as it used to be, proper care and the right nutrients can help the elderly enjoy a healthy and long life.

By: Victoria Care Home