Caregivers Providing End of Life Care Need Support

Family caregivers can find the respite they need

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The daily demands of caregiving for a loved one who is nearing the end of their life can be emotionally and physically draining. The Hospice Foundation of America estimates that almost half a million people, 68 percent being age 65 or older, received hospice care in 2006. For most, that care involved a family caregiver. Many family caregivers must deal with not only the time demands and additional responsibilities, but also the emotional needs of their loved one and family.

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According to the National Family Caregivers Association (NFCA), more than one quarter (26.6 percent) of the adult population has provided care for a chronically ill, disabled or aging family member or friend during the past year. Based on current census data, that translates into more than 50 million people.

The Juggling Act

Recent medical research indicates the stress associated with caregiving can lead to a weakened immune system and in some cases take years off the caregiver's life. Those risks increase when they have to manage caregiving responsibilities while also working or raising a family.

Life can be very stressful for an individual juggling the demands of a job and being a caregiver. Advancing within a career can often be put on hold since completing tasks at work can interfere with caregiving responsibilities.

In many cases, employers will work with the caregiver's changing schedule. Taking time to sit down with a supervisor to explain the situation can be a very good first step to ensuring work commitments are handled. Keeping an employer aware of the situation prevents misinterpretation and promotes better understanding.

Below are a few ideas for the caregiver to keep in mind prior to meeting with their supervisor.

• If others offer to assist with some of their caregiving responsibilities, assign them specific tasks.
• If there is another position available at work that might make the responsibilities easier, ask to move into that job.
• Find out if part time work is an available option and see if it would fit needs at home and fulfill work obligations.
• Look into telecommuting to meet home and work responsibilities.
• Temporary leave from work may help the situation and allow the caregiver to spend more time at home during their loved one's final days.
• View the Family Medical Leave Act, and if applicable discuss this benefit with the employer. Under law, covered employers must grant eligible employees up to 12 weeks of unpaid leave in a 12-month period to care for an immediate family member with a serious health condition. For more information regarding the FMLA, visit the U.S. Department of Labor's website. [http://www.dol.gov/esa/whd/fmla/]

How to Find Respite
Caregiving can often be a 24-hour responsibility, particularly when providing hospice care. There is a risk of emotional burnout and a decline in health for family caregivers who do not take a much needed break. For many, respite care is the best solution.

Respite care provides temporary relief to the primary caregiver. For many, the best solution for temporary care is through the hiring of an outside resource. Companies like Comfort Keepers®, an in-home care provider, offer a range of assistance with a mix of daily living assistance, personal care and homemaking services.

For the nearly 60 percent of family caregivers who are providing care while also working full-time, companies like Comfort Keepers can offer respite. Respite care is a natural extension of Comfort Keepers existing in-home care business. An average of 12 percent of family caregivers have left there jobs as a result of caregiving responsibilities. We'd like to think the services we offer can positively impact the lives of these caregivers.

Additional Support
There are simple ways that others can help family caregivers. The following tips allow non-caregivers to support their family's provider. This list includes realistic examples of how anyone can offer assistance to family caregivers:

1. Call and ask how the caregiver is doing. Don't offer advice, just listen. Being able to vocalize the stress and grief they are experiencing can be a tremendous relief.
2. Offer assistance. Family caregivers often feel like there is never enough time in the day to get the basics done. Offer to walk the dog, mow the yard, pick up groceries or make dinner to allow them to spend more quality time with their loved one.
3. Send a note. A cheerful note or card out of the blue can help brighten their day.
4. Offer the gift of respite. If the caregiver can leave their loved one alone for a few hours, invite them out to dinner, the movies, or for a cup of coffee. Volunteer to stay with the care recipient for a few hours to allow the family caregiver to take a break, or recommend they research an agency with trained caregivers.

End of Life Services
There are several resources for finding compassionate end of life care and respite for family caregivers. The following online resources may answer many questions in the search for the best possible solution:

• http://www.hospicefoundation.org - The Hospice Foundation of America offers an informative article that explores myths about death and pain, and offers insights about grief.
• http://www.cms.hhs.gov - The Centers for Medicare & Medicaid Services provides information about coverage, eligibility and benefits for hospice reimbursement through Medicaid.
• http://www.nahc.org National Association for Home Care and Hospice has an extensive web directory that allows an individual to search for home care and hospice by location, payment types, services offered, and more.
• http://www.nhpco.org - The National Hospice and Palliative Care Organization web site provides information on choosing a hospice, Medicare and Medicaid and basic hospice facts.

About Comfort Keepers in Pinellas County Florida

Caregivers Providing End of Life Care Need Support

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Magical Moments With Lalaloopsy for Your Little Princess

Christmas is coming and getting the right present for a little girl in such a short span of time can be quite a challenge. Anyway, any girl would love to receive a personal gift from the heart, and one of such popular gifts is perhaps the MGA Entertainment Lalaloopsy Dolls by Bitty Buttons. Lalaloopsy Dolls are cute, lovely rag dolls, created with different characters and personalities that will easily capture the heart of any little girl.

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Adult female fans buy and collect these cute dolls to add colors to their cars and bedrooms. At about 7x5x13 inches, a Lalaloopsy doll weighs 3.2 pounds and is suitable for a child ages 6 and up. All Lalaloopsy Dolls come with their pet, a promise certificate and a collectible poster. The head and the hair are made of hard-wearing plastic so you do not have to worry about durability issues or brushing the hair every now and then. The head, arms and legs can be moved and turned, and they have wonderful vivid colors.

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According to the story told by the manufacturer, Lalaloopsy Dolls magically come to live when the last stitches have been sewn. The dolls' personalities and hobbies are based on their specific fabrics, and they have pet friends that somehow correspond to their unique personalities. Take for example, the super-sweet Crumbs Sugar Cookie, which was made from a baker's apron. She loves treats and to make cookies and has a pet mouse, or the Pillow Featherbed, which was made from pieces of baby's blanket. She loves good stories, long naps and lots of snacks. Pillow Featherbed has a pet sheep as her companion. Additionally, Lalaloopsy Dolls have certain sewn dates each. Apparently, the manufacturer puts some thoughts in it too. For instance, Crumbs Sugar Cookie was sewn on December 4th, the National Cookie Day while Pillow Featherbed was sewn on January 3rd, the Festival of Sleep Day. Find which Lalaloopsy Dolls relates most to your little girl and let her bring the magic to live.

Here are the Lalaloopsy Dolls and their personalities to help you find one that suits your little girl most:

Bea Spells-a-Lot: This Lalaloopsy doll was made from a school girl's uniform. She loves to follow rules and talk and she has a pet owl. She was sewn on October 16th (Dictionary Day).

Crumbs Sugar Cookie: She was made from pieces of a baking apron. She has perfect manners and loves inviting friends over for tea. She has a pet mouse and she was sewn on December 4th (National Cookie Day).

Dot Starlight: She was made from a astronaut's space suit, thus she loves science. She has a pet bird and she was sewn on July 20th (the date of the first Man on the Moon).

Jewel Sparkles: Created from remnants of a real princess' dress, Jewel is graceful and loves to dance and wear sparkly clothes, even though she is a little bit bossy at times. She has a Persian cat and she was sewn on March 13th (Jewel Day).

Mittens Fluff 'N' Stuff: Made from pieces of an Eskimo's scarf, Mittens loves hot cocoa and snow fights, among others. She has a polar bear pet and she was sewn on December 21st (1st Day of Winter)

Peanut Big Top: Peanut Big Top was made from bright-colored clown costume. Being a silly prankster who can be clumsy sometimes, she loves to make people laugh and she has a pet elephant. Her sewn on date was April 1st (April fool's Day).

Pillow Featherbed: Created from pieces of a baby's blanket, Pillow loves good stories and long naps. Her favorite snack is milk and cookies and she has a pet sheep. Her sewn on date was January 3rd (Festival of Sleep Day).

Spot Splatter-Splash: Spot was made from a painter's overalls. Thus, she's creative, loves bright colors, and often makes big messes. Her pet is a zebra. Her sewn on date was October 25th (International Artist Day, also Picasso's birthday).

Product Features:

- Adorable rag dolls with different characters and personalities
- Cute pet animal that comes with each Lalaloopsy Doll
- Durable head and hair, movable arms and legs
- Each dolls come with a promise certificate and a collectible poster

Magical Moments With Lalaloopsy for Your Little Princess

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Popular Cave Tours

With constant exploration, the Carlsbad Caverns National Park is able to add new caving tours on occasion. Over the years, the list of caverns has grown quite a bit, and several enjoy constant popularity. One of the most attended of the caving tours is the Hall of the White Giant Tour. This tour can be a bit dangerous, so it is closed to children under twelve years of age, and any children under sixteen years old must have an adult with them.

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There is a good reason for these rules, too. There are a lot of slippery surfaces throughout the Hall of the White Giant Tour, as well as ladders and free climbing. It is really not a place where children can play around, because attention must always be on communication and group safety, and there are many fragile cave formations that can be destroyed by carelessness.

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There are several beautiful cave formations, however, that make the trip worth it. You will see MatlockÕs Pinch, which is a tight, narrow passage, and the White Giant formation. There is an additional fee to visit the Hall of the White Giant Tour.

Adults will pay twenty dollars, while children will get in for ten dollars.

If you are looking for a cave tour the will satisfy the explorer in you, then the Spider Cave is probably the way to go. This is a maze cave, formed by several beautiful passages and a lot of dirty cave crawls. There are several tight spaces, some higher spots, and the possibility of getting pretty dirty.

On your way to the Spider Cave, you will pass through Garden Grove Canyon for about half a mile, but then be ready to crawl. You will see some amazing formations, such as the Mace Room, the Medusa Room, and Cactus Spring. Because the exploring can get a little dangerous, children must also be over the age of twelve to visit this tour, and anyone under the age of sixteen must have an adult with them.

You should make sure that you are fairly physically fit before beginning the tour, because there is a lot of crawling, bending, and climbing that must be done to complete the tour. Also, there is an additional charge for this tour, as well. Adults will pay twenty dollars for the Spider Cave Tour, while children and seniors can get in for ten dollars.

Popular Cave Tours

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How Important is ALA Omega 3 for Health?

ALA omega 3 is a long-chain fatty acid required for many important functions of the body. Flax seed oil is a natural and rich source of ALA omega 3 fatty acid. Fish oil, on the other hand, contains the other two fatty acids which are short-chain counterparts of ALA and are know as DHA and EPA.

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All these fats are considered as good fats and are not found in adequate amounts in our body since the body is unable to manufacture its own fatty acids. In order to address this deficiency, doctors advise people with high blood pressure, high cholesterol, arthritis and mental illnesses to intake omega 3 fats in large amounts through diet and nutritional supplements.

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DHA has been found to be important for the development of the baby's brain. In addition to this, it is also required for the protection of cell membranes. DHA along with other fatty acids helps in the prevention of many deadly diseases including cancer and Alzheimer's disease. These fats are good for pregnant women as they ensure healthy pregnancies and prevent birth defects and miscarriages.

Omega 3 fish oil supplements are becoming increasingly popular among people across the world because they are easy to consume and cause no side effects at all. In addition to this, these fish oil capsules are known to provide long-term health benefits. They contain ALA omega 3 in just the right amount as required by our body. Normally 1 or 2 capsules are enough for an otherwise healthy person to fulfill daily requirements of this fat.

Omega 3 fats reduce inflammation throughout the body and therefore they are recommended to people who suffer from inflammatory conditions like arthritis and cystitis. Oily and fatty fish like herring, salmon, sardines, hoki, mackerel, trout and tuna are mostly used in the making of fish oil supplements because they are high in omega 3 fats.

You need to know that in addition to essential fatty acids, pure fish oil also contains some impurities and contaminants that are harmful for long-term health. These impurities are bacteria, heavy metals like mercury, lead and arsenic, and toxins. It is therefore important to buy pharmaceutical grade fish oil which is first refined and purified and then packaged into capsules.

This high grade fish oil is free from impurities and is approved by health specialists after testing it thoroughly in the laboratory. It does not cause any side effects and is effective for people of all ages.

How Important is ALA Omega 3 for Health?

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Geotechnical Drilling: The 3 Most Common Reasons To Order A Geotechnical Investigation

Geotechnical drilling has become a common factor in facilitating and ensuring the success of engineering plans relating to new building and structure construction and more. In this article, I will cover the 3 most common reasons to order geotechnical investigations and its applications in the commercial construction and in the engineering industry.

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First of all, geotechnical drilling is very useful and often required by law to investigate a new building site. To make sure that a site is appropriate for the new construction, a geotechnical investigation makes sure that the soil is safe to build on and that there are no large rocks that could make the structure collapse. Often, laws require that a site be verified for safety before approving a building permit.

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Besides, safety reasons for ordering a geo environmental investigation, the second reason to order a geotechnical drilling rig is to facilitate the building of foundations that are far superior to conventional piling. After obtaining soil samples from the geotechnical drillers, geotechnical engineers are able to conceive and elaborate economically sound plans for foundational support that will best support buildings structurally. Based on the results of geo tech drilling, the foundation construction industry has been dramatically improved and has allowed for ultimate results in the construction of tall buildings, bridges, piers and levees.

The third most common reason to order a geotechnical investigation is to detect and assist in the remediation of contaminated soil. Since contaminated oil or water can harm living organisms including people, it is crucial to detect any leakage caused by underground fuel tanks or caused by waste disposal in a careless manner. Geotechnical drilling comes into the picture in phase II of an environmental site assessment. This usually occurs when a site changes owners.

A Canadian ESA (environmental site assessment) includes three phases. A phase 1 assessment detects if there is evidence of contamination. It includes research on the history of the site and an on site investigation and report put together by a qualified environmental consultant. If there is evidence of potential contamination, a phase II investigation is then ordered. This second phase will confirm the presence of contamination and is largely assisted through geotechnical drilling. A phase II environmental investigation includes drilling, sampling, testing and groundwater monitoring through wells installed by the geo tech drillers. Phase III is when remediation is put into place if contamination levels are unacceptable. A phase III investigation will determine which methods can be used to clean up or at least contain the contaminants.

Geotechnical Drilling: The 3 Most Common Reasons To Order A Geotechnical Investigation

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Disappearing Land - Where Is the Farmland Going?

It takes a notoriously long amount of time for soil to be made. Under normal agricultural conditions it usually takes between 200 and 1,000 years for one inch of topsoil to be formed.

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There are estimates that, dependent on where it is happening in the world topsoil is currently being lost sixteen to three hundred times faster than it will take for it to be replaced.

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Many negative environmental impacts are a result of either land being converted to agricultural use or of the misuse of fertilizers and pesticides. By 1990, approximately 38% of the roughly 600 million acres of the world's cropland had been degraded because of the poor agricultural practices that had gone on over the years.

Although some of the land was only partially degraded a substantial amount was severely damaged. Much of the land was so damaged that it was either completely taken out of production or its productive capacity was greatly diminished.

Since 1990 soil has continued to be lost to severe soil degradation to the tune of 2 to 2 1/2 million acres per year.

And, in the long run, when soil degrades less food can be grown.

There are a number of reasons that degradation occurs. The best known reason is soil erosion.

Approximately 67% of topsoil is washed away by water. The wind accounts for the balance.

Farmland is often physically degraded due to mechanical tilling. Mechanical tilling can lead to soil crusting and compaction.

If crops are repeatedly grown without any adequate fallow periods, soil gets damaged. When agricultural chemicals are over applied they can kill the beneficial organisms within the soil and deplete soil of its nutrients.

When water is not properly managed on irrigated cropland, degraded farmland is a common result. Salt levels often build to toxic levels in soil that is inadequately drained and consequently waterlogged.

Approximately 10% to 15% of all the irrigated land in the world now suffers, to some degree, from salinization and waterlogging. Consequently, productive capacity in the world is now being significantly threatened.

Ironically, the total production of food throughout the world has actually increased over the years. However this is because of the increased use of fertilizer and higher densities of crops, It is just a matter of time before the results of soil degradation caused by these processes becomes irreversible throughout the world.

It is already happening in some parts of the world. Losses from soil erosion in Africa are approximately 8%. Data from a number of studies indicate that soil degradation may have caused more than a 20% loss in productivity in a number of Middle Eastern and Asian countries.

Disappearing Land - Where Is the Farmland Going?

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Multifamily Debt Factors For Investors

First, I will offer a few pointers on debt. Contrary to much of the popular literature, few properties can be bought for no cash down toward the purchase price. For regulatory reasons, banks are generally prevented from doing this. For practical reasons, no lender should do this. If the investment goes badly, the bank needs to be able to assume ownership at a level that should protect their invested capital. In general, projects can be planned as follows:

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70% to 75% of Loan to Value, 1.30-1.35 Debt Service Coverage Ratio(DSCR),

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However, given recent events, I advise setting up your project with more conservative ratios than these as well. I recommend a 60% Loan to Value and a 1.4 Debt Service Coverage Ratio. This level of conservatism protects assets from banking risk, cash flow risk, etc. and therefore protects all the equity and bank debt involved in the project.

Also, many sellers and brokers will attempt to close a deal on projected pro forma. The wise buyer only buys on the basis of actual income and expenses and then seeks to achieve pro forma. There are exceptions in cases where the buyer has identified immediate actions placing the project on the correct footing for his post closing financials. However, purchases based on appreciating rents into an infinite future ignore that financial cycles often create issues for these purchases.

Loan Brokers

A loan broker working with the banks or other sources of capital can be invaluable. The main questions to determine whether a specific broker can be an effective member of your team are:

What relationship do they have with the likely appraisers and engineers that the loan source will use? Will the loan source prevent their involvement with the appraiser or engineer? What loan sources do they have and what volume of business have they closed within the past 12 month period per source? How long have they worked with each source? What portion of their loan application close? Of those that don't close, why not and when in the process was this determined?

A strong loan broker significantly streamlines the process and effectively assures a much greater probability of success. Because of their easy access to the lender and supporting financings routinely, they can facilitate legal, financial, and report completion supporting preparing and completing the total loan package.

Over time as your company develops strong banking relationships, the need for loan brokers may become negligible, but as an entity with more limited asset brokers can be a strong addition to your staff capability.

For sources of loan brokers, most property brokerages can offer a list of active loan brokers for any given market. In some cases, the property brokerages offer loan and equity brokerage services directly.

Institutional Capital

This capital is normally not available without access through a brokerage with major fund contacts and generally is reserved for larger projects. The typical sources of funds are large hedge funds, pension funds, large corporation, and some investment funds. Generally, an investor's business plan will have to mature to a scale that attracts this capital.

Agency Debt

Agency debt refers to guaranteed programs from FHA, Fannie Mae, and Freddie Mac. FHA provides some loans directly to the borrower. Fannie Mae and Freddie Mac do not.

Terms from these sources are typically:

Personal guarantees not required (generally no spousal signatures) with the exception of "bad boy clauses" related to fraud situations. Normally these loans include lock out periods followed by expensive penalty periods for early payoff. These loans are usually assumable Rates are usually 90 to 200 basis points above the 5 year treasury, erm is normally 5 to 20 years, Bridge loans with interest only terms and with construction allowances are often available. Initial purchase loans are normally 75% Loan to Value (LTV) Debt service coverage (DSCR) is normally 1.3 to 1.35.

Normally the borrower must provide:

A Property Condition Report (PCR)-or engineering study A Phase I environmental study (ESA) - or environmental report A property appraisal UCC search for liens and other encumbrances An Alta Survey (with some exceptions allowed) A full title search and bring down Insurance at closing

Additionally, the borrower generally provides:

Organizational documents including OA and articles of incorporation. Certification of EIN, Past Tax Statements, YTD and past year financials, Property tax records, Personal financial statements for the partners, 2 years past tax returns for the partners, Pro Forma Financials, A business plan

Fees are usually 1.25% to 2.25% to close.

Regional and National Banks

These are the typical sources of capital for commercial projects. In fact, for multifamily, they are often better sources than local banks as they have groups specializing in agency loan tools and organizations tooled to support multifamily specifically. 

Terms from these companies are typically:

Personal guarantees required (generally no spousal signatures), Rates are usually 200 to 350 basis points above the 5 year treasury, Term is normally 3 to 5 years, Bridge loans with interest only terms and  with construction allowances are often available. Initial purchase loans are normally 75% Loan to Value (LTV) Debt service coverage (DSCR) is normally 1.3 to 1.35.

Normally the borrower must provide:

A Property Condition Report (PCR)-or engineering study A Phase I environmental study (ESA) - or environmental report A property appraisal UCC search for liens and other encumberances An Alta Survey (with some exceptions allowed) A full title search and bring down Insurance at closing

Additionally, the borrower generally provides:

Organizational documents including OA and articles of incorporation. Certification of EIN, Past Tax Statements, YTD and past year financials, Property tax records, Personal financial statements for the partners, 2 years past tax returns for the partners, Pro Forma Financials, A business plan

Fees are usually 1% to 2% to close.

Conduit Lenders

These loans are typically long term and low rate. However, they considerably restrict the flexibility of the borrower to refinance or sell the project.

Terms from these sources are typically:

Personal guarantees not required (generally no spousal signatures) with the exception of "bad boy clauses" related to fraud situations. Normally these loans include lock out periods followed by expensive penalty periods for early payoff. These loans are usually not assumable. Rates are usually 90 to 200 basis points above the 5 year treasury, Term is normally 5 to 20 years, Bridge loans with interest only terms and with construction allowances are often available. Initial purchase loans are normally 75% Loan to Value (LTV) Debt service coverage (DSCR) is normally 1.3 to 1.35.

Normally the borrower must provide:

A Property Condition Report (PCR)-or engineering study A Phase I environmental study (ESA) - or environmental report A property appraisal UCC search for liens and other encumberances An Alta Survey (with some exceptions allowed) A full title search and bring down Insurance at closing

Additionally, the borrower generally provides:

Organizational documents including OA and articles of incorporation. Certification of EIN, Past Tax Statements, YTD and past year financials, Property tax records, Personal financial statements for the partners, 2 years past tax returns for the partners, Pro Forma Financials, A business plan

Fees are usually 1% to 2% to close.

Local Banks

Terms from these companies are typically:

Personal guarantees required (generally no spousal signatures), Rates are usually 200 to 350 basis points above the 5 year treasury, Term is normally 3 to 5 years, Bridge loans with interest only terms and with construction allowances are often available. Initial purchase loans are normally 75% Loan to Value (LTV) Debt service coverage (DSCR) is normally 1.3 to 1.35.

Normally the borrower must provide:

A Property Condition Report (PCR)-or engineering study A Phase I environmental study (ESA) - or environmental report A property appraisal UCC search for liens and other encumberances An Alta Survey (with some exceptions allowed) A full title search and bring down Insurance at closing
Additionally, the borrower generally provides:

Organizational documents including OA and articles of incorporation. Certification of EIN, Past Tax Statements, YTD and past year financials, Property tax records, Personal financial statements for the partners, 2 years past tax returns for the partners, Pro Forma Financials, A business plan
Private Debt

Terms from these sources are typically:

·         Personal guarantees are required often with spousal signatures. ·         These loans are usually not assumable. ·         Rates are usually 250 to 450 basis points above the 5 year treasury, ·         Term is normally 1 to 2 years with an additional 6 months to 1 year option, ·         Bridge loans with interest only terms and with construction allowances are often available. ·         Initial purchase loans are normally 60% to 65% Loan to Value (LTV) ·         Debt service coverage (DSCR) is normally 1.3 to 1.35.

Normally the borrower must provide:

A Property Condition Report (PCR)-or engineering study A Phase I environmental study (ESA) - or environmental report A property appraisal UCC search for liens and other encumberances An Alta Survey (with some exceptions allowed) A full title search and bring down Insurance at closing

Additionally, the borrower generally provides:

Organizational documents including OA and articles of incorporation. Certification of EIN, Past Tax Statements, YTD and past year financials, Property tax records, Personal financial statements for the partners, 2 years past tax returns for the partners, Pro Forma Financials, A business plan

Fees are usually 1% to 2% to close.

Multifamily Debt Factors For Investors

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