Choosing Childcare

December 8, 2009 by  
Filed under Education

There are several child-care options available to you, depending on your preferences, your budget, and your schedule. Here are some ideas and some guidelines to follow when pursuing your child-care needs.

In-Home:

1. Nannies are hired specifically to care for children. They typically do not work around the home that does not relate to the children. Nannies are available on a full-time or part-time basis, and can live with you or come to your house each day. Some nannies have extensive practical experience while others may have been professionally trained.

2. Housekeeper/caregivers are also available full or part-time, and can live in or out of the home. They provide the advantage of taking care of the home and the kids simultaneously. However, if children are younger, and demand much more attention and care than older kids, a housekeeper may not be able effectively to maintain both responsibilities.

3. Au pairs are usually young, live-in women and men who do light housekeeping chores and care for kids in exchange for room and board. Often college and university students are interested in this type of work, but if they are foreigners, make sure they have proper visas and work permits.

4. Shared care is an option some parents pursue. In this setting, several families hire a caregiver who rotates between the families??? homes. This alternative provides a personalized care program which parents are able to design themselves at a lower cost.

Outside the Home:

1. Child-care centers are the most common child-care alternative outside the home. Not all centers will provide the services which you consider important. Some centers offer excellent, personalized services, and others do not. Care must be taken in selecting a center for your child. Some things to check for include staff qualifications, safety of the facility, activities, proper licensing, and caregiver-to-child ratio.

2. Family-care homes are another option. Many parents prefer family care homes over day-care centers for very young children because of the continuity provided by a single caregiver. Family-care homes tend to have less structured programs than child-care centers. Some things to check for include safety of the environment, proper licensing, and the number and ages of the other children in the home.

Interviewing Care Providers

Be sure to include the following questions when interviewing a care provider.

  • What experience have you had in providing care? Look for a variety in family makeup and ages, and the length of experience.
  • What do you do if a baby cries? Look at the problem-solving process of the person. Does the person mention things like trying several things to solve the problem or checking everything a second time?
  • How would you discipline a child? Look for their basic philosophy. Do they believe in physical punishment, or providing positive reinforcement? Is their approach to discipline the same as yours?
  • Ask about feeding schedules and meals. Are they organized and conscientious? Are you satisfied with the food choices?

Evaluate the Setting

  • Does the center have a license that meets state regulations?
  • Does the care provider have adequate education, training, and proper credentials?
  • Ask for references from past employers or other parents.
  • Does the care provider have procedures in case of emergency
  • Is the center safe? (Covered outlets, no sharp corners, cleaners out of reach, etc.)
  • Inquire into sanitary procedures. Do staff and children wash their hands regularly, and particularly after diaper changes or before food preparation?
  • Have fire extinguishers been inspected recently and have smoke detectors been installed?
  • Do they have liability insurance?

Evaluate the Care Providers

  • Are the staff members friendly and helpful?
  • Do you trust them?
  • Do the care providers treat the children as individuals?
  • Are they involved with the children or do they just provide basic needs?
  • Do they show patience with the kids?
  • Do they have a sense of humor and seem warm and affectionate?
  • Are they in good physical condition and able to play with the kids?
  • Do you approve of their methods of toilet training and other self-help skills?
  • Are their philosophical or religious beliefs compatible with yours?
  • Do they seem open to communication with you?

Evaluate the Environment and Program

  • Is the atmosphere cheerful and pleasant?
  • Is there an adequate play area – both indoors and outside?
  • Are there adequate toys which are clean and well-maintained?
  • Are activities and rest periods scheduled or flexible?
  • Are the activities creative and interesting?
  • Is there a drop-in policy for parents?
  • Is there a mechanism for the home/day -care transition and vice versa?
  • Can this provider and setting allow personal attention for your child?

Remember to be open and talk with your co-workers about your breast-feeding. Try to gain their support and interest.

Tags: Family child care, Day care, Child care, Nanny, Childcare

Choosing a Rehab Program

December 8, 2009 by  
Filed under Education

The doctor and other hospital staff will provide information and advice about rehabilitation programs, but the patient and family make the final choice. Hospital staff know the patient’s disabilities and medical condition.

They should also be familiar with the rehabilitation programs in the community and should be able to answer questions about them. The patient and family may have a preference about whether the patient lives at home or at a rehabilitation facility. They may have reasons for preferring one program over another. Their concerns are important and should be discussed with hospital staff.

Things To Consider When Choosing a Rehabilitation Program

  • Does the program provide the services the patient needs?
  • Does it match the patient’s abilities or is it too demanding or not demanding enough?
  • What kind of standing does it have in the community for the quality of the program?
  • Is it certified and does its staff have good credentials?
  • Is it located where family members can easily visit?
  • Does it actively involve the patient and family members in rehabilitation decisions?
  • Does it encourage family members to participate in some rehabilitation sessions and practice with the patient?
  • How well are its costs covered by insurance or Medicare?
  • If it is an outpatient or home program, is there someone living at home who can provide care?
  • If it is an outpatient program, is transportation available?

A person may start rehabilitation in one program and later transfer to another. For example, some patients who get tired quickly may start out in a less intense rehabilitation program. After they build up their strength, they are able to transfer to a more intense program.

When Rehabilitation Is Not Recommended
Some families and patients may be disappointed if the doctor does not recommend rehabilitation. However, a person may be unconscious or too disabled to benefit. For example, a person who is unable to learn may be better helped by maintenance care at home or in a nursing facility. A person who is, at first, too weak for rehabilitation may benefit from a gradual recovery period at home or in a nursing facility. This person can consider rehabilitation at a later time. It is important to remember that:

Hospital staff are responsible for helping plan the best way to care for the patient after discharge from acute care. They can also provide or arrange for needed social services and family education.

This is not the only chance to participate in rehabilitation. People who are too disabled at first may recover enough to enter rehabilitation later.

Tags: Healthcare, Healthcare in the United States, Nursing, Rehabilitation medicine, Geriatric rehabilitation, Geriatrics, Nursing home, Stroke recovery

Deciding on a Stroke Rehab Center

December 8, 2009 by  
Filed under Education

Some people do not need rehabilitation after a stroke because the stroke was mild or they have fully recovered. Others may be too disabled to participate. However, many patients can be helped by rehabilitation. Hospital staff will help the patient and family decide about rehabilitation and choose the right services or program.

Types of Rehabilitation Programs
There are several kinds of rehabilitation programs:

  • Hospital programs
  • These programs can be provided by special rehabilitation hospitals or by rehabilitation units in acute care hospitals. Complete rehabilitation services are available. The patient stays in the hospital during rehabilitation. An organized team of specially trained professionals provides the therapy. Hospital programs are usually more intense than other programs and require more effort from the patient
  • Nursing facility (nursing home) programs
  • As in hospital programs, the person stays at the facility during rehabilitation. Nursing facility programs are very different from each other, so it is important to get specific information about each one. Some provide a complete range of rehabilitation services; others provide only limited services
  • Outpatient programs
  • Outpatient programs allow a patient who lives at home to get a full range of services by visiting a hospital outpatient department, outpatient rehabilitation facility, or day hospital program
  • Home-based programs
  • The patient can live at home and receive rehabilitation services from visiting professionals. An important advantage of home programs is that patients learn skills in the same place where they will use them

Individual Rehabilitation Services
Many stroke survivors do not need a complete range of rehabilitation services. Instead, they may need an individual type of service, such as regular physical therapy or speech therapy. These services are available from outpatient and home care programs.

Paying for Rehabilitation
Medicare and many health insurance policies will help pay for rehabilitation. Medicare is the Federal health insurance program for Americans 65 years of age or over and for certain Americans with disabilities. It has two parts: hospital insurance (known as Part A) and supplementary medical insurance (known as Part B). Part A helps pay for home health care, hospice care, inpatient hospital care, and inpatient care in a skilled nursing facility. Part B helps pay for doctors’ services, outpatient hospital services, durable medical equipment, and a number of other medical services and supplies not covered by Part A. Social Security Administration offices across the country take applications for Medicare and provide general information about the program.

In some cases, Medicare will help pay for outpatient services from a Medicare-participating comprehensive outpatient rehabilitation facility. Covered services include physicians’ services; physical, speech, occupational, and respiratory therapies; counseling; and other related services. A stroke survivor must be referred by a physician who certifies that skilled rehabilitation services are needed.

Medicaid is a Federal program that is operated by the States, and each State decides who is eligible and the scope of health services offered. Medicaid provides health care coverage for some low-income people who cannot afford it. This includes people who are eligible because they are older, blind, or disabled, or certain people in families with dependent children.

These programs have certain restrictions and limitations, and coverage may stop as soon as the patient stops making progress. Therefore, it is important for patients and families to find out exactly what their insurance will cover. The hospital’s social service department can answer questions about insurance coverage and can help with financial planning.

Tags: hospital insurance, supplementary medical insurance, Health economics, Geriatrics, Medicare, Healthcare in the United States, Nursing, Medicaid

Finding Good Childcare

November 22, 2009 by  
Filed under Education

This information is on finding good childcare. You’ll learn where to find childcare and how to evaluate your choices for childcare. Read more

Tags: Yellow, family day, Childcare, Day care, Nursing home, employee assistance counselor

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