Thursday, July 26th, 2012 | Posted by AIDS.gov By AIDS.gov
By Ken Bridbord, M.D., M.P.H., Director, Division of International Training and Research, Fogarty International Center, U.S. National Institutes of HealthDr. Ken Bridbord Dr. Bridbord was a co-chair of the International AIDS Conference in 1987. Conversations I had with colleagues in June of 1987, during the last AIDS meeting held here in Washington, inspired me to develop a program that would create HIV/AIDS research expertise in the regions where the need was greatest.
Read the original here: 25 Years of HIV/AIDS Training has Transformed the Research Landscape
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With all the rumors circulating concerning the release of the windows phone 8, all of those previous leaks and rumors rather focused on the interface or the operating system of the windows phone 8 along its possible quality of display.
Yet, today, some great news ever befalls on the cyber world concerning windows phone 8. Ever remember that moment when Amazon beat the other retail giants such as Google and Apple in the cloud music game? That moment deserved by Amazon was due to its Cloud Player application.
Windows Phone 8 Cloud Player
The application allows users to directly stream the music they bought from Amazon. Apart from the music bought online via Amazon, users of the Cloud Player application were also enjoying the convenience of easily uploading all the personal music collection they store to have them all transferred into their mobile devices. So, what?s the big news for windows phone 8? The breaking news is that, while the Cloud Player application has already been made available for Android and Apple iOS, recent postings have also revealed that the same may be offered to Windows Phone. And what?s the next model this fall, again? No other than the windows phone 8!
Summing up the great features so far revealed via leaks and rumors, you can expect windows phone 8 to be the most fab mobile device ever made by Windows. The Start Screen feature, the bigger tiles on its touch screen, the MicroSD support, the USB Mass Storage support, multi-core system and now the Cloud Player! What more do you actually need from a mobile phone that is not offered and displayed in the Windows Phone 8? Plus not to mention a real gaming experiencing through the phone?s Xbox Live! Ah! The day can last with you and your phone alone and you are still enjoying the fun!
Fall is fast approaching. If you are anticipating with all your heart with the upcoming release of the windows phone 8, as of the moment, hold it yet and save the surprise this coming fall! Many developers? attention is already geared towards its release as well!
Source: ?winsource.com
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About Mighty Sam
Mighty Sam has written 11 post in this blog.
The name is Mighty Sam and I am the Mighty new writer who can fly !!!! Oh yeah and I loooooove my Windows Phone
As a good business owner, you surely should help your employees to get workers compensation insurance because this insurance does not only protect your working capital but also helps protecting your employees? financial condition. When an unexpected thing happens to your employee, your employee can use workers compensation insurance to cover all the expenses. Since there is more than one provider of workers compensation insurance, you surely can find this insurance easily. However, because insurance rate plays a crucial role in determining the amount of money that should be paid every month, you should manage to find workers compensation insurance that has the lowest rate.?
To find missouri workers compensation that has the lowest rate, you now can do it over the internet. As you surely have known, various things can be found or do on internet. Whether you want to buy insurance or to chat with an insurance agency, you can do it easily online. This is possible because there are lots of insurance websites these days. Those insurance websites are usually the official websites of insurance companies but there are also insurance websites that feature insurance quotes from multiple companies. If you visit the last websites, you will be able to get as many quotes as possible easily.?Basically, in order to find the lowest missouri workers compensation rates on internet, the first thing that you have to do is to shop around. You have to collect insurance quotes at least from three multiple insurance companies in order to find a more accurate result. For this purpose, you just need to visit official websites of insurance companies or an online directory of insurance companies. Whatever option that you choose, you will be able to find the lowest deal on workers compensation insurance easily. So, if you have been trying to find the lowest rate for workers compensation insurance, you had better go online.
FILE - In this file photo made June 8, 2012, Stanford pitcher and first-round draft pick Mark Appel throws during a NCAA college baseball tournament super regional game against Florida State in Tallahassee, Fla. Appel spurned the Pittsburgh Pirates and decided to remain at Stanford for his senior season, one of the first big casualties of baseball's new restrictions on amateur signing bonuses. Appel is the only one not to sign out of 31 first-round picks. Under the labor deal, the deadline for draft picks to sign was Friday, July 13, 2012, a month earlier than under the previous deal. (AP Photo/Phil Sears, file)
FILE - In this file photo made June 8, 2012, Stanford pitcher and first-round draft pick Mark Appel throws during a NCAA college baseball tournament super regional game against Florida State in Tallahassee, Fla. Appel spurned the Pittsburgh Pirates and decided to remain at Stanford for his senior season, one of the first big casualties of baseball's new restrictions on amateur signing bonuses. Appel is the only one not to sign out of 31 first-round picks. Under the labor deal, the deadline for draft picks to sign was Friday, July 13, 2012, a month earlier than under the previous deal. (AP Photo/Phil Sears, file)
In this file photo made Feb. 14, 2012, Stanford pitcher Mark Appel smiles during an NCAA college baseball practice at Stanford University in Palo Alto, Calif. Appel spurned the Pittsburgh Pirates and decided to remain at Stanford for his senior season, one of the first big casualties of baseball's new restrictions on amateur signing bonuses. Appel is the only one not to sign out of 31 first-round picks. Under the labor deal, the deadline for draft picks to sign was Friday, July 13, 2012, a month earlier than under the previous deal. (AP Photo/Paul Sakuma, file)
NEW YORK (AP) ? Spending by teams in baseball's amateur draft dropped by 11 percent in the first year of restrictions imposed by the new labor contract.
Teams allocated $207.7 million to draft picks, down from $233.6 million last year though still the second-highest annual total, according to figures compiled by Major League Baseball. The decline in the first round was even more pronounced, a 17 percent fall from $89.5 million to $74.3 million this year.
Just 10 teams exceeded their signing bonus pool, incurring a total luxury tax of $1.5 million. But no team reached the second level of the tax, which would cause a club to forfeit its next first-round draft pick.
Under the latest labor deal, two aims were to slow spending on prospects through the draft and to get picks to sign sooner.
"We think that the system performed well in its initial year," said Rob Manfred, MLB's executive vice president of economics and league affairs. "It accomplished the goal, in our view, which was to allow the weakest teams with the best opportunities to get the best talent."
Teams pick in the reverse order of their record the previous year. Baseball's new labor deal assigned each club a bonus pool ? the sum of the recommended draft bonuses for a team's selections in the first 10 rounds.
The decline in spending was the first since a fall from $158.9 million in 2006 to $154.5 million the following year.
"It is hard to draw conclusions about these new provisions based on only one year's experience," union head Michael Weiner said. "Is that a function of the players available in this year's draft? Is that a function of something else? I think with one year, it's hard to say."
Going into the draft, many club scouts said the top talent available was not as good as it was in 2011.
"The general perception was we would be down this year because of the perception in the quality of the draft," Manfred said.
Showing how teams managed their money, the Chicago White Sox and Detroit each spent the exact amount of their respective bonus pools. Toronto spent exactly 5 percent more than its pool ? a total of $9.27 million that led to a tax of $330,900. Under the escalating penalties, if the Blue Jays had spent one additional dollar, they would have lost their next first-round pick.
Will any team spend into the second level of penalties?
"That's an example of needing more than one year's experience," Weiner said.
Stanford pitcher Mark Appel was the chief casualty. Projected by some to be the top pick, he was taken by Pittsburgh with the eighth selection and declined a $4.8 million offer. Appel will stay at Stanford for his senior year and be eligible for next year's draft.
"Clubs that wanted to pick the players they wanted couldn't," said Appel's adviser, Scott Boras, a frequent critic of the new rules. "Because of the system, they could not spend what was needed to sign the best player. They had to make alternate choices. That's not what the draft was designed to do."
He cited Baltimore (fourth overall pick), Kansas City (fifth) and the Chicago Cubs (sixth) as teams that decided to pass on players because of the new restrictions. He also said the system caused a shift in spending habits on amateur players.
In the year ending July 1, teams committed $76.9 million in bonuses on players from the Dominican Republic and Venezuela, according to MLB, up from $57.5 million the previous year. Spending on Cubans rose from $27 million to $109 million ? because of four sought-after players.
Under the signing year that started July 2, each team is limited to $3.2 million on international signings ? not including any bonus of $7,500 or less. A management-union committee is studying whether to have an international draft for 2014 or later.
Both management and the union agree that the changes achieved a goal of getting more players in a professional environment faster: 73.6 percent of drafted players signed, up from 63.5 percent last year. Among the first 10 rounds, the percentage rose to 97.6 percent from 91.5 percent.
As part of the new labor contract, the deadline to sign was moved up to July 13 this year from Aug. 15. Fewer players waited until the last day to reach an agreement, with deadline-day deals dropping to 10 from 70.
For the past 3 years, the EVO conference at The Canyons in Park City, UT has become a highlight for our family. The first two years we brought our daughter and a friend; this year it was just me and my sweets, and we had the best time.
(Photo by Kristen.)
If you?re a blogger and have never been to a conference before, this event is an all-around favorite for so many, partly because it?s so family-friendly.
The closing party is always open to all family members, and held up at the Park City Mountain Resort.
(Dine and Dish, Tip Junkie, Lick my Spoon, A Southern Fairytale, getting ready for the Alpine Slide!)
It also cracks me up that my husband was one of only a handful of male bloggers at the conference (after all, the name stands for Evolution of Women in Social Media). He fit right in. But seriously, anyone can register, and you?ll learn a LOT. And he did learn a lot, as a new blogger himself, and had many conversations on the topic of bullying.
The best part of a conference is not only learning, whether you?re new or not, but meeting like-minded bloggers, hearing inspiring speakers, and getting to know vendors who participate. Jyl and the Mom it Forward Team do a spectacular job planning this event with sponsors involved.
This year I was sponsored by Harry and David, a ?fruit and gifting? company in my home town of Medford, Oregon. Yes, the Harry and David! It seems everyone has some kind of inspirational story to share about their H&D experience. Mary Shanahan, who is the Senior Director of Brand Marketing for H&D, accompanied me and my husband, and hosted a small, intimate dinner party for a handful of bloggers.
It was a blast introducing Mary to so many great people, and showing her how a blogging conference works!
Here?s Mary with us bloggers outside the Waldorf Astoria Slopes Restaurant at The Canyons where we enjoyed a fantastic meal, hosted by Harry and David. (Flavia, me, Mary, Maria, Helen, Kelley, Heidi, and Alison.)
This very classy restaurant not only fed us amazing food, they made a very special dessert for us at the end of our meal?Harry & David?s Moose Munch Chocolate Bananas!
This year Harry & David gave beautiful pear gift baskets to all of the EVO speakers, and we were able to participate in the ?Meet and Treat? where vendors who are a part of EVO have the opportunity to connect with other bloggers by hosting a giveaway, handing out coupons, or engaging in other creative interaction with attendees, during a sponsored breakfast.
So not only did we have a great time, with new friendships made, old ones rekindled, the power also went out one night (lots of excitement), and the weather was all over the map in this very beautiful setting. (The stormy view from our room.)
The mountains were as gorgeous as ever (you know how mountain weather goes, sunny one minute, rainy the next).
The closing party was a blast! (Me with Dine and Dish and I Wash You Dry.)
Good food, excitement, fun, friends ? you can?t ask for any more!
I?ll be sharing later about my workshop on the hill at Look Out Cabin, hosted by Mizkan, which was such an honor for me to be a part of. Stay tuned for a future post.
Oh, and if you ever come to visit us in Medford, look what greets you at the airport as you pass through security ?
Have you heard about the EVO conference?
Have you ever been to Medford, Oregon to tour Harry and David orchards and facilities?
Ingredients
1 10-oz. bag of Harry and David dark chocolate truffles
1 10-oz. bag of Harry and David Moose Munch snack
4 large bananas
Instructions
Place truffles in a microwave-safe container. Microwave at 50% power for 1-minute at a time. Stir in-between intervals, for a total of approximately 3 minutes, until melted.
Place Moose Munch snack into a large resealable bag; use a rolling pin to crush into small pieces.
Peel and cut the bananas into approximately 2-inch lengths, then dip each piece of banana into the melted chocolate and roll in the crushed Moose Munch snack.
Place on baking sheet and refrigerate for 15-minutes before serving.
Preparation time: 5 minute(s)
Cooking time: 15 minute(s)
Number of servings (yield): 4
Harry and David sponsored my trip to EVO ?12; all opinions are my own. Dessert pics are Foodie Crush?s iPhone pics. Thanks Heidi!
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Barbara Rose Brooker has written a romantic novel that can mostly occur to people associated with a age. The interesting thing is always that her lovers are inside their 70s. They hold the usual struggles Levitra using the dynamics of relationships, nevertheless they bring a lot more baggage off their relationships together with health concerns and end of life issues. The tendency in the public is to want to determine people of their 70s as beyond romance and relationship issues. As Baby Boomers age inside their 60s, more and more with the public are learning to find out elderly people the means by which Barbara Rose Brooker portrays them.
The protagonists are Anny and Marv. Each is a veteran internet dater plus they meet through JDate. Anny violates all the guidelines of internet dating safety by meeting him with a bar after which getting into his car and planning to his place for the first date. He begins levitra kissing her and, not surprisingly, asks for sex right over bat. She negotiates this mine field and comes out safely, reaching the conclusion that Marv levitra just isn't for her.
"Obviously, Marv's not relationship material. He's into image, money - levitra not to mention he's still in love along with his ex-wife. He's a cliche, living on his past glamour. Anyway, I prefer professorial types. And haven't I needed enough with emotionally unavailable men? Relationships which are nowhere? Am I once again attracted with a man I don't like?" (p. 7)
We hear many times that Marv is emotionally unavailable. When he or she is after sex, he could be charming and attentive. After sex, there is no emotional warmth remaining as they wants the woman to hurry away and make sure to look at everything she brought with her. Younger crowd lies about his involvement with women, denying that they is entangled regarding his ex-wife despite the actual fact levitra that her watch can be found in his bed and denying which he remains participating in JDate though Anny can embark on JDate and tell which he is immediately trying to find other women just after they'd sex together.
Needless to say, Anny features a torrid affair with Marv and experiences emotional conflict the years they are together. She writes a column and begins to make use of Marv as material. She writes "a compilation of columns about an emotionally unavailable, shallow seventy-five-year-old man who cannot face age levitra and is also always about the prowl for any young, gorgeous,, and ideal woman, who'll lead him to feel young and powerful." (p. 13) Her desire to end the partnership with Marv conflicts with her wish to use him for material, to be with her column becomes an excellent success due to her series on Marv and she or he needs him for further material.
This novel needs being read. It is written with a woman in her 70s in regards to a couple of their 70s. It handles problems that Baby Boomers are beginning to confront. Yes, people inside their 70s are using online dating quite successfully. Yes, people in their 70s can nevertheless be sexually active and remain looking for satisfying relationships. Healthy people within their 70s are living life at full stride rather than necessarily winding down. Barbara Rose Brooker's picture of life for folks in their 70s levitra is required in our graying society.
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[ [ [['did not go as far his colleague', 8]], '29438204', '0' ], [ [[' the 28-year-old neighborhood watchman who shot and killed', 4]], '28924649', '0' ], [ [['because I know God protects me', 14], ['Brian Snow was at a nearby credit union', 5]], '28811216', '0' ], [ [['The state news agency RIA-Novosti quoted Rosaviatsiya', 6]], '28805461', '0' ], [ [['measure all but certain to fail in the face of bipartisan', 4]], '28771014', '0' ], [ [['matter what you do in this case', 5]], '28759848', '0' ], [ [['presume laws are constitutional', 7]], '28747556', '0' ], [ [['has destroyed 15 to 25 houses', 7]], '28744868', '0' ], [ [['short answer is yes', 7]], '28746030', '0' ], [ [['opportunity to tell the real story', 7]], '28731764', '0' ], [ [['entirely respectable way to put off the searing constitutional controversy', 7]], '28723797', '0' ], [ [['point of my campaign is that big ideas matter', 9]], '28712293', '0' ], [ [['As the standoff dragged into a second day', 7]], '28687424', '0' ], [ [['French police stepped up the search', 17]], '28667224', '0' ], [ [['Seeking to elevate his candidacy back to a general', 8]], '28660934', '0' ], [ [['The tragic story of Trayvon Martin', 4]], '28647343', '0' ], [ [['Karzai will get a chance soon to express', 8]], '28630306', '0' ], [ [['powerful storms stretching', 8]], '28493546', '0' ], [ [['basic norm that death is private', 6]], '28413590', '0' ], [ [['songwriter also saw a surge in sales for her debut album', 6]], '28413590', '1', 'Watch music videos from Whitney Houston ', 'on Yahoo! Music', 'http://music.yahoo.com' ], [ [['keyword', 99999999999999999999999]], 'videoID', '1', 'overwrite-pre-description', 'overwrite-link-string', 'overwrite-link-url' ] ]
Contact: Marla Paul marla-paul@northwestern.edu 312-503-8928 Northwestern University
Agencies place unqualified, possibly criminal caregivers in homes of vulnerable seniors
CHICAGO --- If you hire a caregiver from an agency for an elderly family member, you might assume the person had undergone a thorough criminal background check and drug testing, was experienced and trained for the job.
You'd be wrong in many cases, according to new Northwestern Medicine research.
A troubling new national study finds many agencies recruit random strangers off Craigslist and place them in the homes of vulnerable elderly people with dementia, don't do national criminal background checks or drug testing, lie about testing the qualifications of caregivers and don't require any experience or provide real training.
"People have a false sense of security when they hire a caregiver from an agency," said lead study author Lee Lindquist, M.D., an associate professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "There are good agencies out there, but there are plenty of bad ones and consumers need to be aware that they may not be getting the safe, qualified caregiver they expect. It's dangerous for the elderly patient who may be cognitively impaired."
(See Lindquist's "10 Questions to Ask Before Hiring a Caregiver" below.)
The study will be published in the July 13 issue of the Journal of American Geriatrics Society.
Lindquist, a geriatrician, personally has seen a number of bad caregivers accompanying patients in her clinic. "Some of the paid caregivers are so unqualified it's scary and really puts the senior at risk," she said.
Lindquist had a 103-year-old patient whose illiterate caregiver was mixing up her own medications and the patient's medications. The caregiver was giving her own medicines to the elderly patient by mistake. Another patient had dropped 10 percent of her weight and developed pressure ulcers because her caregiver was not properly feeding her or getting her out of bed.
"It was easier for the caregiver to sit and watch TV and not to try to feed the patient or move her," Lindquist said.
Several agencies surveyed in the study actually made up names of screening tests they claimed to give their job applicants.
"We had agencies say they used a 'National Scantron Test for Inappropriate Behavior' and an 'Assessment of Christian Morality Test'," Lindquist said. "To our knowledge, these tests don't exist. If you're not a smart consumer, you won't recognize which agencies are being deceitful."
Identifying the good agencies from the bad is difficult because many agencies have slick websites and marketing campaigns, she added.
"It's a cauldron of potentially serious problems that could really hurt the senior," Lindquist said. "These agencies are a largely unregulated industry that is growing rapidly with high need as our population ages. This is big business with potentially large profit margins and lots of people are jumping into it."
For the study, researchers posed as consumers and surveyed 180 agencies around the country about their hiring methods, screening measures, training practices, skill competencies assessments and supervision. They found:
Only 55 percent of the agencies did a federal background check.
"A number of agencies don't do a federal background check or look at other states besides their own," Lindquist said. "Someone could move from Wisconsin to Illinois and could have been convicted of abusing an elder adult or theft or rape and the agency would never know."
Only one-third of agencies interviewed said they did drug testing.
"Considering that seniors often take pain medications, including narcotics, this is risky," Lindquist said. "Some of the paid caregivers may be illicit drug users and could easily use or steal the seniors' drugs to support their own habits."
Few agencies (only one-third) test for caregiver skill competency. A common method of assessing skill competencies was "client feedback," which was explained as expecting the senior or family member to alert the agency that their caregiver was doing a skill incorrectly.
"How do you expect a senior with dementia to identify what the caregiver is doing wrong?" Lindquist asked.
Many agencies (58.5 percent) use self-reports in which they ask the caregiver to describe their own skills. "In the hunt for a job, some people may report they can do tasks that in reality they have no idea how to do," Lindquist said. "We found agencies sending caregivers out into the seniors' home without checking."
Inconsistent supervision of the caregiver.
Agencies should send a supervisor to do a home visit to check on the caregivers more frequently initially and then at least once a month. But this only occurred with 30 percent of the agencies.
"Amazingly, some agencies considered supervision to be asking the caregiver how things were going over the phone or when the employee stopped in to get their paycheck," Lindquist said.
With seniors wishing to remain in their own homes, paid caregivers fill an important role.
"The public should demand higher standards, but in the short term, seniors need to be aware what explicitly to look for when hiring a paid caregiver through an agency," Lindquist said.
Below are Lindquist's 10 questions to ask an agency prior to hiring a paid caregiver:
10 QUESTIONS TO ASK BEFORE HIRING A CAREGIVER
1. How do you recruit caregivers, and what are your hiring
requirements?
2. What types of screenings are performed on caregivers before you
hire them? Criminal background checkfederal or state? Drug screening?
Other?
3. Are they certified in CPR or do they have any health-related training?
4. Are the caregivers insured and bonded through your agency?
5. What competencies are expected of the caregiver you send to the
home? (These could include lifting and transfers, homemaking skills, personal care skills such as bathing, dressing, toileting, training in behavioral
management and cognitive support.)
6. How do you assess what the caregiver is capable of doing?
7. What is your policy on providing a substitute caregiver if a regular caregiver cannot provide the contracted services?
8. If there is dissatisfaction with a particular caregiver, will a substitute be provided?
9. Does the agency provide a supervisor to evaluate the quality of home care on a regular basis? How frequently?
10. Does supervision occur over the telephone, through progress
reports or in-person at the home of the older adult?
###
This study was funded by grant K23AG028439 from the National Institute on Aging of the National Institutes of Health.
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Contact: Marla Paul marla-paul@northwestern.edu 312-503-8928 Northwestern University
Agencies place unqualified, possibly criminal caregivers in homes of vulnerable seniors
CHICAGO --- If you hire a caregiver from an agency for an elderly family member, you might assume the person had undergone a thorough criminal background check and drug testing, was experienced and trained for the job.
You'd be wrong in many cases, according to new Northwestern Medicine research.
A troubling new national study finds many agencies recruit random strangers off Craigslist and place them in the homes of vulnerable elderly people with dementia, don't do national criminal background checks or drug testing, lie about testing the qualifications of caregivers and don't require any experience or provide real training.
"People have a false sense of security when they hire a caregiver from an agency," said lead study author Lee Lindquist, M.D., an associate professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital. "There are good agencies out there, but there are plenty of bad ones and consumers need to be aware that they may not be getting the safe, qualified caregiver they expect. It's dangerous for the elderly patient who may be cognitively impaired."
(See Lindquist's "10 Questions to Ask Before Hiring a Caregiver" below.)
The study will be published in the July 13 issue of the Journal of American Geriatrics Society.
Lindquist, a geriatrician, personally has seen a number of bad caregivers accompanying patients in her clinic. "Some of the paid caregivers are so unqualified it's scary and really puts the senior at risk," she said.
Lindquist had a 103-year-old patient whose illiterate caregiver was mixing up her own medications and the patient's medications. The caregiver was giving her own medicines to the elderly patient by mistake. Another patient had dropped 10 percent of her weight and developed pressure ulcers because her caregiver was not properly feeding her or getting her out of bed.
"It was easier for the caregiver to sit and watch TV and not to try to feed the patient or move her," Lindquist said.
Several agencies surveyed in the study actually made up names of screening tests they claimed to give their job applicants.
"We had agencies say they used a 'National Scantron Test for Inappropriate Behavior' and an 'Assessment of Christian Morality Test'," Lindquist said. "To our knowledge, these tests don't exist. If you're not a smart consumer, you won't recognize which agencies are being deceitful."
Identifying the good agencies from the bad is difficult because many agencies have slick websites and marketing campaigns, she added.
"It's a cauldron of potentially serious problems that could really hurt the senior," Lindquist said. "These agencies are a largely unregulated industry that is growing rapidly with high need as our population ages. This is big business with potentially large profit margins and lots of people are jumping into it."
For the study, researchers posed as consumers and surveyed 180 agencies around the country about their hiring methods, screening measures, training practices, skill competencies assessments and supervision. They found:
Only 55 percent of the agencies did a federal background check.
"A number of agencies don't do a federal background check or look at other states besides their own," Lindquist said. "Someone could move from Wisconsin to Illinois and could have been convicted of abusing an elder adult or theft or rape and the agency would never know."
Only one-third of agencies interviewed said they did drug testing.
"Considering that seniors often take pain medications, including narcotics, this is risky," Lindquist said. "Some of the paid caregivers may be illicit drug users and could easily use or steal the seniors' drugs to support their own habits."
Few agencies (only one-third) test for caregiver skill competency. A common method of assessing skill competencies was "client feedback," which was explained as expecting the senior or family member to alert the agency that their caregiver was doing a skill incorrectly.
"How do you expect a senior with dementia to identify what the caregiver is doing wrong?" Lindquist asked.
Many agencies (58.5 percent) use self-reports in which they ask the caregiver to describe their own skills. "In the hunt for a job, some people may report they can do tasks that in reality they have no idea how to do," Lindquist said. "We found agencies sending caregivers out into the seniors' home without checking."
Inconsistent supervision of the caregiver.
Agencies should send a supervisor to do a home visit to check on the caregivers more frequently initially and then at least once a month. But this only occurred with 30 percent of the agencies.
"Amazingly, some agencies considered supervision to be asking the caregiver how things were going over the phone or when the employee stopped in to get their paycheck," Lindquist said.
With seniors wishing to remain in their own homes, paid caregivers fill an important role.
"The public should demand higher standards, but in the short term, seniors need to be aware what explicitly to look for when hiring a paid caregiver through an agency," Lindquist said.
Below are Lindquist's 10 questions to ask an agency prior to hiring a paid caregiver:
10 QUESTIONS TO ASK BEFORE HIRING A CAREGIVER
1. How do you recruit caregivers, and what are your hiring
requirements?
2. What types of screenings are performed on caregivers before you
hire them? Criminal background checkfederal or state? Drug screening?
Other?
3. Are they certified in CPR or do they have any health-related training?
4. Are the caregivers insured and bonded through your agency?
5. What competencies are expected of the caregiver you send to the
home? (These could include lifting and transfers, homemaking skills, personal care skills such as bathing, dressing, toileting, training in behavioral
management and cognitive support.)
6. How do you assess what the caregiver is capable of doing?
7. What is your policy on providing a substitute caregiver if a regular caregiver cannot provide the contracted services?
8. If there is dissatisfaction with a particular caregiver, will a substitute be provided?
9. Does the agency provide a supervisor to evaluate the quality of home care on a regular basis? How frequently?
10. Does supervision occur over the telephone, through progress
reports or in-person at the home of the older adult?
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This study was funded by grant K23AG028439 from the National Institute on Aging of the National Institutes of Health.
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Public release date: 10-Jul-2012
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