America’s Family Caregivers Can’t Wait: Tell Congress to Pass the RAISE Act Now Guest Post by Nancy A. LeaMond

Originally Posted on 08/22/2016


After Labor Day, when Congress returns from its summer recess, there will only be 33 working days left for the U.S. House of Representatives before the end of the year. That’s not a lot of time to address some of our nation’s biggest challenges. One item awaiting action that should be an immediate priority is the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act.  This bipartisan, commonsense step to aid America’s greatest support system — family caregivers — is long overdue.

Passed unanimously by the U.S. Senate, the RAISE Act would develop a national strategy to support family caregivers, bringing together stakeholders from the public and private sectors — including state and local officials, health care and long-term services and support providers, employers, federal agencies, older adults, persons with disabilities and family caregivers themselves — to identify specific actions communities, providers, government, employers and others can take, including with respect to: promoting person- and family-centered care in a range of settings; assessment and service planning involving both care recipients and family caregivers; information, education, referral and care coordination; and respite options so caregivers can reset and recharge.
Today, more than 40 million family caregivers care for veterans, parents, spouses, children and adults with disabilities and other loved ones so they can continue to live at home. The unpaid care family caregivers provide — valued at about $470 billion annually — helps delay or prevent more costly care and unnecessary hospitalizations, saving taxpayer dollars.

I know from firsthand experience that caring for a loved one is a tremendous responsibility. While I have much in common with my fellow caregivers, my experience is unique in many ways. Indeed, each of our caregiving experiences is individual, seen through our own personal family lens. Everyday duties can include bathing and dressing; preparing and feeding meals; transportation; handling financial, health care and legal matters; and often complex medical tasks like wound care. Many family caregivers are working full time and raising families. They are often on call 24/7.

That’s why AARP, together with a number of other organizations and family caregivers themselves, is calling for the U.S. House to pass the RAISE Act now.   

One such organization, the Elizabeth Dole Foundation, works with military and veteran caregivers. In a recent radio news story, former senator Dole said:

“Five and a half million military and veteran caregivers are caring for loved ones with devastating wounds, illnesses and disabling injuries — visible and invisible. By passing the RAISE Act, we can create an important path forward so military family caregivers, all family caregivers, get the support they need.”

Another group pressing the U.S. House to pass the RAISE Act is Autism Speaks. Executive Vice President of Programs and Services Lisa Goring says:

“Millions of family members are forced to step in as full-time caregivers to keep their loved ones with autism and other developmental disabilities safe and supported. Now is the time for a national strategy to support all family caregivers to ensure their loved ones a better future.”

For me, it’s the stories and experiences of family caregivers that really underscore why the RAISE Act must pass now. Britnee Fergins cares for her father. She says:

“My 91-year-old father, who’s a World War II veteran, requires a lot of attention. I also have a very energetic 3-year-old son — and work 12-hour shifts as a chemist. It’s a constant juggling act, and some days, I’m afraid I’m going to drop the ball.”

Family caregiving is a unique and deeply personal issue that affects just about all of us, wherever we are on the political and ideological spectrum. We are either family caregivers now, were in the past, will be in the future — or will need care ourselves one day.

The RAISE Act would implement the bipartisan recommendation of the federal Commission on Long-Term Care, requiring the development of a national strategy to support family caregivers, similar in scope to the national strategy developed to address Alzheimer’s disease. The need is urgent and time this year is running out.

AARP urges the U.S. House to pass the RAISE Family Caregivers Act now. And I urge you to contact your representative about the RAISE Act today.  Call 844-259-9351 or click here.

The following U.S. representatives are cosponsors of the bipartisan RAISE Act as of Aug. 22:

Lead Sponsors
Reps. Gregg Harper (R-Miss.) and Kathy Castor (D-Fla.)


Rep. Lujan Grisham (D-N.M.)

Rep. Black (R-Tenn.)

Rep. Pascrell (D-N.J.)

Rep. Emmer (R-Minn.)

Rep. Pocan (D-Wis.)

Rep. Deutch (D-Fla.)

Rep. Katko (R-N.Y.)

Rep. Pompeo (R-Kan.)

Rep. O’Rourke (D-Texas)

Rep. Amodei (R-Nev.)

Rep. Duckworth (D-Ill.)

Rep. Chu (D-Calif.)

Rep. Schakowsky (D-Ill.)

Rep. Fortenberry (R-Neb.)

Rep. Gibson (R-N.Y.)

Rep. Pingree (D-Maine)

Rep. Bonamici (D-Ore.)

Rep. Napolitano (D-Calif.)

Rep. Lujan (D-N.M.)

Rep. Hastings (D-Fla.)

Rep. Kirkpatrick (D-Ariz.)

Rep. Kuster (D-N.H.)

Rep. Blumenauer (D-Ore.)

Rep. Lofgren (D-Calif.)

Rep. Freylinghuysen (R-N.J.)

Rep. Murphy (R-Pa.)

Rep. Frankel (D-Fla.)

Rep. Dingell (D-Mich.)

Rep. Lee (D-Calif.)

Rep. Brady (D-Pa.)

Rep. Rice (D-N.Y.)

Rep. DesJarlais (R-Tenn.)

Rep. Beatty (D-Ohio)

Rep. Davis (D-Calif.)

Rep. Beyer (D-Va.)

Rep. Roe (R-Tenn.)

Rep. Stefanik (R-N.Y.)

Rep. Courtney (D-Conn.)

Rep. Langevin (D-R.I.)

Rep. Meehan (R-Pa.)

Rep. Kilmer (D-Wash.)

Rep. Takano (D-Calif.)

Rep. Payne (D-N.J.)

Rep. Allen (R-Ga.)

Rep. Ashford (D-Neb.)

Rep. Peters (D-Calif.)

Rep. Matsui (D-Calif.)

Rep. Larson (D-Conn.)

Rep. Denham (R-Calif.)

Rep. Bishop (R-Mich.)

Rep. Hunter (R-Calif.)

Rep. Smith (D-Wash.)

Rep. Meng (D-N.Y.)

Rep. Cramer (R-N.D.)

Rep. Clark (D-Mass.)

Rep. Boyle (D-Pa.)

Rep. Esty (D-Conn.)

Rep. Dold (R-Ill.)

Rep. Thompson (R-Pa.)

Rep. Lipinski (D-Ill.)

Rep. Messer (R-Ind.)

Rep. Jenkins (R-Kan.)

Rep. Moore (D-Wis.)

Rep. Smith (R-N.J.)

Rep. Clarke (D-N.Y.)

Rep. Watson Coleman (D-N.J.)

Rep. Carolyn Maloney (D-N.Y.)

Rep. MacArthur (R-N.J.)

Rep. Curbelo (R-Fla.)

Rep. Wasserman Schultz (D-Fla.)

Rep. Grayson (D-Fla.)

Rep. Corrine Brown (D-Fla.)

Rep. Takai (D-Hawaii)

Rep. Joe Heck (R-Nev.)

Rep. Cicilline (D-R.I.)

Rep. Joe Wilson (R-S.C.)

Rep. Frederica Wilson (D-Fla.)

Rep. Bennie Thompson (D-Miss.)

Rep. Peter King (R-N.Y.)

Rep. Sessions (R-Texas)

Rep. McKinley (R-W.Va.)

Rep. Slaughter (D-N.Y.)

Rep. Simpson (R-Idaho)

Rep. Kelly (D-Ill.)

Rep. Nolan (D-Minn.)

Rep. Holmes Norton (D-D.C.)

Rep. Capps (D-Calif.)

Rep. Zeldin (R-N.Y.)

Rep. Guinta (R-N.H.)

Rep. Miller (R-Mich.)

Rep. Walberg (R-Mich.)

Rep. LoBiondo (R-N.J.)

Rep. Tonko (D-N.Y.)

Rep. LaHood (R-Ill.)

Rep. Lance (R-N.J.)

Rep. Sean P. Maloney (D-N.Y.)

Nancy LeaMond, chief advocacy and engagement officer and executive vice president of AARP for community, state and national affairs, leads government relations, advocacy and public education for AARP’s social change agenda. LeaMond also has responsibility for AARP’s state operation, which includes offices in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands.

You can follow her on Twitter @NancyLeaMond.

Free Veterans Eligibility Calculator Guest Post Originally Published in Senior Blog Living

Free Veterans Eligibility Calculator


There are many benefits out there for veterans, but sometimes determining eligibility can be confusing. recently released an eligibility benefit calculator for the VA Aid and Attendance benefit to you help simplify the process for you and your loved ones. Get started to discover how your family can save both time and money.

The VA Aid and Attendance Benefit and Veterans Eligibility

Hundreds of thousands are eligible for this little-known, yet incredibly helpful, VA benefit, including spouses of veterans. Funds can be used to help pay for senior care and offer financial aid to the veterans and their family who deserve them. A Place for Mom has helped guide more than 410,000 veterans in their searches for senior care and housing, and part of this assistance is educating families about the benefits they have earned, but may not know about.

This is where Veteran Aid’s helpful calculator comes in handy as a two-minute questionnaire will help you determine if your family has VA funds waiting for you to claim.

Education is king when it comes to funding retirement and senior care costs. Every little bit of financial assistance can help; especially if it’s money a veteran in your family has already earned. Here are a few ways the VA Aid and Attendance benefit can assist your family:

  1. The Veterans Aid and Attendance (A&A) Pension provides benefits that reduce the cost of care for veterans and surviving spouses who require assisted living.
  2. The A&A Pension can provide up to $1,788 per month to a veteran, $1,149 per month to a surviving spouse, or $2,120 per month to a couple. A veteran filing with a sick spouse is eligible for up to $1,406 per month.
  3. Like Social Security, this pension is dependable and is paid directly to you by the Department of Treasury.

Overview of Questions You Will Be Asked About Veterans Eligibility

If you want to gather information ahead of time, the eligibility calculator will ask the following questions to help determine eligibility:

1. Who are you looking for?

Are you looking for financial assistance for yourself, a parent, grandparent, other relative, or friend? You will need to specify in the questionnaire.

2. Are you or is your spouse a veteran?

You will need to determine whether either you or your spouse served the country in active duty.

3. Did you serve at least 90 days of active duty with at least 1 day during one of these approved periods of war?

To be eligible for benefits, a veteran must have served at least 90 days of active duty, with one or more of those days occurring during wartime. This does not mean that the veteran had to see actual combat.

If the active duty occurred after September 7, 1980, you must have served at least 24 months or the full period that you were called to duty.

The VA’s dates of wartime are as follows:

  • Mexican Border War: May 9, 1916, through April 5, 1917
  • WWI: April 6, 1917, through November 11, 1918, extended to April 1, 1920, for those who served in the Soviet Union
  • WWII: December 7, 1941, through December 31, 1946, extended to July 25, 1947, where continuous with active duty on or before December 31, 1946
  • Korean Conflict: June 27, 1950, through January 31, 1955
  • Vietnam Era: August 5, 1964, through May 7, 1975. February 28, 1961, through May 7, 1975, for a veteran who served in the Republic of Vietnam during that period
  • Persian Gulf War: August 2, 1990, through a date to be prescribed by Presidential proclamation or law.91

4. Was the veteran honorably discharged from service?

The veteran had to be honorably discharged from service to be eligible for the benefit.

5. Do any of the following currently pertain to your parent(s) assistance needs?

In this question, you will determine what activities of daily living (ADLs), such as getting dressed, eating or using the restroom, your loved one may need assistance with.

If you or your loved one qualifies for the benefit, you will be directed to the “How to Apply” page, and will be given additional veteran senior care information and helpful resources.

Benefits Your Family Has Earned

Sadly, around 69% of veterans are completely unaware of the benefits available to them — and that means many veterans are paying more for their care than they should.

At A Place for Mom, our goal is to help families find the right senior care solution. For many families in the U.S., the hardest part of the process isn’t finding the right community, it’s figuring out how to pay for it, and the VA Aid and Attendance benefit calculator can help!

More than one third of Americans over 65 are either wartime veterans or the spouses of wartime vets. These individuals may qualify for a pension program through the Department of Veteran Affairs (VA), commonly referred to as “Aid & Attendance,” yet only a small fraction of those who are eligible actually know about this benefit. So get started today. Paying for senior living may be intimidating, but there are many resources available for our veteran senior loved ones. Educate yourself and try the A&A benefit eligibility calculator. You have nothing to lose!

Do you or a loved one have veterans benefits? What would you like to let other families know about the veterans eligibility process? Share your story with us in the comments below.

Related Articles:

Free Veterans Eligibility Calculator posted by Dana Larsen

About the Author

Dana Larsen is a writer, artist, editor, dancer and food-enthusiast living in the Pacific Northwest. Originally from Alaska, Dana has a passion for the outdoors and finding life’s next adventure. She graduated with honors from the University of Washington with a degree in English and Communications, and her writing has appeared in a variety of digital and print publications. She loves connecting audiences with ideas and is also an advocate for enhancing care and support for those affected by Alzheimer’s and other dementias. View.

13 Dangers of Caregiver Denial Guest Post By Dana Larsen

care for the caregiver

Originally Posted on A Place for Mom: Senior Living Blog on September 28, 2015


Denial is a normal human emotion, especially with symptoms as heartbreaking as dementia or Alzheimer’s, as no one wants to confront the disease for which there is currently no cure. But there are risks to caregiver denial.

Dangers that go along with caregiver denial are two-fold. Not only is your loved one at risk; but also you, the caregiver, is at risk. Learn more about the 13 dangers of caregiver denial and get some survival tips from acclaimed author and caregiver, Elizabeth Lonseth.

Dangers of Caregiver Denial

It doesn’t matter how many times you’ve been through the caregiving experience. It never gets easy. But a little education helps, and there are definitely some good pointers to keep in mind. Elizabeth Lonseth, author of “A Gradual Disappearance” — a concise, intimate and sincere guide for people dealing with Alzheimer’s disease or dementia — is a seasoned caregiver who has watched not only both her parents be diagnosed with memory impairment, but also both her husband’s parents. Her fourth time around is still difficult, but at least she has some awareness to help guide her in the Alzheimer’s journey.

“I was in my 30s when my dad was diagnosed with dementia. I didn’t know how to deal with it and was in denial. Guilt was also a problem. Then, eventually, my husband’s parents were both diagnosed and my husband and I went through the myriad of emotions and caregiving challenges with them, as well. My mom’s Alzheimer’s diagnosis is the 4th time around. It’s still hard, but mom played a role in her choices as I was educated on what I needed to do and how to get things in order.”

Elizabeth has been asked to speak to many caregivers and senior care professionals who have been affected by Alzheimer’s and dementia. Denial was a key theme and problem she discovered from her audiences, so she decided to write a book about the dangers of denial, which comes out on October 14, 2015. This interview is a sneak peek at the gems of wisdom you can expect from her upcoming book, “The Dangers of Denial: Embracing the Challenges of Alzheimer’s and Dementia.”

7 Dangers of Denial for the Patient

“Denial is a tool. It protects us. But if we stay in denial, it becomes a problem… sometimes with dire consequences,” Elizabeth notes. “People try to hide their problems. But if both the patient and their loved ones ignore changes in behavior, even if they are subtle, this can lead to problems.” An Alzheimer’s or dementia patient only has a small window of being objective. If they can confront the problems they’re experiencing in a timely manner, they can participate in decisions that involve their care and finances.

Here are seven dangers that can occur that Alzheimer’s and dementia caregivers need to be cognizant of when caring for their aging loved one:

1. They can get lost.

This is pretty straightforward. The brain doesn’t remember directions or locations as it did before memory impairment; even if the person has been to a destination a thousand times before. If your loved one gets lost they can get hurt or panic, which only leads to more problems.

2. They can hurt themselves or others.

If your loved one tries to do everything as they’ve always done, but in reality they require supervision, they are bound to hurt themselves or others. For example, ignoring the fact that they need a walker can lead to a fall, resulting in broken bones, displaced joints, hospitalizations and the use of pain medication. Also if a wife with memory impairment is caring for her elderly husband or vice versa, she could unintentionally hurt her spouse in every day care.

3. They can have a home accident.

Leaving your loved one unsupervised could lead to accidents in the kitchen, bath, stairs or around the house. Fires could even occur.

4. They can suffer from poor nourishment.

Shopping and eating healthy requires proper planning and cooking techniques. If a loved one has memory impairment, he or she will more than likely not be eating healthy. This is why it is so crucial to regularly check cabinets to survey whether healthy foods have been purchased and to make sure your loved one doesn’t look sick or too thin.

5. They can cause an accident from driving.

Surprisingly accidents from senior driving don’t happen very often, but when they do, they’re catastrophic. Your loved one, pedestrians and other innocent bystanders could be hurt or even killed in the event of an accident.

Elizabeth shares a story she remembers about an elderly gentleman who shouldn’t have been driving:

“In the late 1970s we were gardening in the front yard of our home in Seattle. A car came down our narrow street on Queen Anne Hill. It ripped the side mirror off our truck, and sideswiped our neighbor’s car, and continued to roll slowly on down the street. My husband took off running and easily caught up with the elderly man at the wheel, who was oblivious to the damage he had caused. My husband jogged alongside the car, talking to the gentleman for another half block before he convinced the driver to pull over. My husband found out where he lived and drove him home. His wife drove my husband back and surveyed the damage. She promised her husband would not get behind the wheel again. We could only hope that was the case.”

6. They can overdose on medications.

Overdosing on medications is quite common for seniors who suffer from Alzheimer’s or dementia. Organizing medications for your loved one to take on their own can even create problems as they may not understand the days of the week or whatever dispensing system you may have in place.

7. They can become a victim of elder abuse.

Elder abuse can be subtle. Husband or wife caregivers can have good intentions, but not understand they are being abusive. For example, Elizabeth discusses a situation she heard of where a husband was trying to make his wife better again. He was “yelling at his wife to get up and do the dishes, not realizing she mentally or physically could not.”

Elizabeth candidly notes that there are more problems that she discusses in detail in the book, but the ones listed are the biggest ones she has encountered in her experience as a caregiver in addition to questions and problems from audience members during her speaking engagements.

6 Dangers of Denial for Family Members: by            Elizabeth Lonseth

Family members also suffer from denial that their loved ones have dementia and Alzheimer’s, according to Elizabeth. Having a realistic perspective about your loved one’s illness and his or her needs is crucial if you’re thinking about their wellbeing. But it can be hard for family members to accept that their parent, spouse or family member has changed. It’s even worse when both the elderly loved one with the problem and the family member is in denial:

“When loved ones and family members are both in denial, this presents a huge problem as it puts the sufferer at risk, not to mention, they can’t participate enough in the decision making for their care needs.”

Here are the six dangers of denial for family members that Elizabeth discusses:

1. Losing the chance to make special memories.

If you’re in denial and walking on eggshells trying to avoid signs of the disease, you’re probably not going toenjoy the time you have left with your loved one. For example, Elizabeth didn’t get a lot of quality time with her dad as she was so young when he was diagnosed and she didn’t know how to deal with the disease:

“I was in denial with my father and I avoided visiting him as often as I used to. It was so painful seeing this brilliant geneticist no longer able to hold a long, intelligent conversation. His communication skills became that of a young child. So instead of visiting every month like I had been, I came every other month or every three… Deep in denial, I lost the chance to create special memories with my father.”

Elizabeth happily mentions that she and her mom are still having a great time because she is not in denial and knows what to expect from the disease: “I did get mom to laugh on Monday quite a bit, so that was wonderful.”

2. Forfeiting being the best advocate for your loved one.

If you’re in denial, you can’t be your loved one’s advocate. Someone who doesn’t love them may have to take over, which can create even more problems, both emotionally and financially.

3. Not getting legal papers in order.

“Without Power of Attorney (POA), you’re not going to get anywhere with anything,” comments Elizabeth. Whether it’s social security, IRS, or even utility companies or banks. People need to know you’re the one in charge.

4. Family conflict.

Family conflict can create all kinds of frustrations for everyone. If some of the members are in denial, it adds to the conflict; and maybe even an old conflict can resurface. The family members in denial don’t help out and the aware ones take on multiple burdens; sometimes on their own. Often the ones in denial accuse their siblings of ‘over reacting.’

5. Loss of financial resources.

If someone is suffering from memory impairment, they are no longer fit to handle their finances. If the family member or caregiver ignores what’s was going on with mom and dad, stocks will get sold at the wrong time and sometimes bank accounts can be completely wiped out.

Elizabeth warns that it’s hard because often parents and/or loved ones don’t want to let you in. “Finances are private. Parents don’t want to share this information with their children. But it’s crucial you discuss financial plans ahead of time so that your family doesn’t fall under financial hardship.”

6. Stress involving illnesses and even the death of the caregiver before the patient passes away.

It’s not uncommon for family caregivers to put their own health at risk when they are in denial about the help they need caring for a loved one. Lonseth points out that family caregivers over age 66 have a 63% higher mortality rate than non-caregivers, and that “often the caregiver dies before the loved one they are taking care of does.”

In fact, Elizabeth notes, “There are couples who have been married 40-60 years, and one goes down hill and the other doesn’t want the rest of the world to know. The caregiver gets sick and the person with dementia doesn’t have care.”

This is especially scary. Family’s need to be cognizant of this sort of problem to prevent it from happening.

Survival Tips and Tips for Facing Denial for Dementia Caregivers

It’s no secret that Alzheimer’s and dementia can take a toll on caregivers. Elizabeth graciously shares some of the tips that have worked well to help embrace the disease as well as survive the disease as a caregiver once denial is no longer an issue:

Tips on Facing Denial

  • Start writing in a journal to get your thoughts on paper and identify fears or anger you may be experiencing (these are key emotions in denial)
  • Seek out a friend or loved one to talk to about your denial
  • Recognize that anger is a sign
  • Make it a team effort comprised of friends and family members as the support will help everyone involved
  • Get educated: The sooner, the better, from, APFM blog and newsletter (subscribe on the right column), or the MayoClinic blog and newsletter (subscribe on the left column)

Basic Survival Tips

  • Take a break
  • Use humor to help you through
  • Get a support group
  • Seek professional help

Embracing Memory Care

“The Dangers of Denial” is an expansion on “A Gradual Disappearance.” The short, easy-to-read guide is a complete focus on the denial aspect of Alzheimer’s and dementia as Elizabeth feels so many caregivers and family members need to be aware of the risks involved in denial.

Elizabeth discusses that there are many levels of denial. For example, you may acknowledge that your loved one suffers from memory impairment, but you may think professional help is not needed. “Many people think they can provide all the care themselves. But the truth is, there is awareness, education and medical knowledge that is needed. If your loved one is diagnosed with a heart problem and they need surgery, you wouldn’t take them home. Memory care needs to be approached in the same way. You need help, even if it’s someone coming to the home to provide care,” Elizabeth comments.

So take heed of Elizabeth’s expert advice.Talk to your loved one’s doctor about your options. Research memory care communities near you, and most of all – recognize when there’s a problem and be your loved one’s advocate. No one knows them better than you.

Elizabeth’s latest book comes out October 14. For more information, view her website.

About Elizabeth Lonseth

In addition to “A Gradual Disappearance,” Elizabeth Lonseth is the author of a pair of Christian fiction novels set in the Pacific Northwest: “Leave it With Him” and “Cares of This World.” You can learn more about Lonseth’s life and work, or inquire about speaking engagements, at her

About the Author

Dana Larsen is a writer, artist, editor, dancer and food-enthusiast living in the Pacific Northwest. Originally from Alaska, Dana has a passion for the outdoors and finding life’s next adventure. She graduated with honors from the University of Washington with a degree in English and Communications, and her writing has appeared in a variety of digital and print publications. She loves connecting audiences with ideas and is also an advocate for enhancing care and support for those affected by Alzheimer’s and other dementias. View .



Originally published in the AORN Periop Insider Weekly Newsletter  July 28, 2016.      Authored by Carina Stanton

The term “bully” is often used incorrectly to classify both bullies and those expressing incivility. Understanding the distinction between the two can help to put structure around communication and action in attempts to weed out bad behavior in perioperative nursing care, according to nursing Career Coach Phyllis Quinlan, PhD, RN-BC.

“The 10% of nurses who are true bullies have a personality defect,” Quinlan says. “Knowing the distinction is key to protecting your staff and deciding whether to develop a plan of remediation or to get rid of a toxic staff member.”

Understanding Incivility vs. Bullying

Quinlan describes bullying as a threatening behavior based in intimidation that stems from the bully’s issue with personal power. “For a bully, their personal power is far more important than the other person’s needs—if the other person needs to feel supported, a bully says ‘tough.’”

A person who indulges in bullying is very egocentric and has far more limited opportunity for personal growth, introspection and a commitment to change.

In the practice setting, a bully will intimate to someone that “you are on your own, if you don’t do what I want I have the power to isolate you,” Quinlan explains. She says bullying is not distinct to one professional level because this bad behavior knows no direction. It can be top down (leadership to staff), down up (staff to leadership) or lateral (peer to peer).

Although incivility is also bad behavior, it stems more from not being fully respectful of the other person’s perspective. Incivility is commonly seen by Quinlan during patient hand-offs or when a patient is transferred to a different area of care, such as from the OR to PACU. “As the nurse is explaining the patient’s state and previous care, an uncivil reaction by the nurse listening is to act as though they are being inconvenienced or worse to provide negative judgment about the previous care, making the nurse handing off the patient feel as though they must justify themselves and their actions.

With 80% of communication being non-verbal, much uncivil behavior is expressed with a less-than-polite facial expression or a toe-tapping type of stance indicating the nurse talking should speed it up and finish what they are saying.

Seeing Bad Behavior as Neurotic Need

One common thread between incivility and bullying is denial of wrongdoing. “If you ask an uncivil or bullying nurse to assess their behavior, they will report they were unaware of wrong doing and may say the nurse who reported their behavior was ‘too sensitive’ or ‘took it the wrong way.’”

Yet research indicates that both uncivil and bullying nurses essentially know exactly what they are doing because it fills a neurotic need.

Quinlan recalls the words of Abraham Lincoln, in which he suggested you can see the character of a person when you give them power. “Someone with good character will take a role in power and be collegial, find common ground and be generous enough to give praise for a job well done. On the flip side, someone with problematic character will use a power role to offer criticism and make remarks that are self-serving.”

Catching It Early

For new employees, Quinlan recommends a set time frame for a probationary period in which the hire is observed for both clinical and behavioral performance. Quinlan says nurses who are good clinically but lacking in collegial behavior are often kept on staff to work on the behavior piece, what she hears nurses refer to as the “soft stuff.”

“Nonsense, behavior is the tough stuff and should be viewed as equally important to clinical skills,” Quinlan stresses. She advises a strong collaboration between nursing, hospital administration and human resources to establish strict behavioral boundaries that are reviewed wisely through the probationary period to measure knowledge, skills and behavioral benchmarks that are demonstrative of culture.

“Make sure everyone is on same sheet of music with clear descriptives of bullying and incivility weaved into your code of conduct and stand behind a zero-tolerance approach to toxic behavior,” she suggests. “If a true bully is identified, cut your losses quickly, otherwise you will lose good staff members.”

For Managers

Register now to attend “Bringing Shadow Behavior into the Light of Day: Understanding and Addressing Incivility and Bullying Behavior,” AORN’s Nurse Executive Leadership Seminar with Phyllis Quinlan, and get the skills to build your own zero-tolerance policies and practices against bullying and incivility.

Top 8 Activities For Caregivers to Enjoy With Those They Care For: A Guest Post by Anna


Being a caregiver means not only taking care for someone’s physical needs, but also communicating effectively with this person. No one wants to be sick and/or old and you need to cheer up the one you want to help.

Since caregiving is not an easy task, here is a list of top activities which you should do as a caregiver. Thus, you will be able to make the life of the one you are caring for really better.

  1. Listen to music together

This is something which does not require a physical effort and is great for the soul. Music helps people relax and enjoy their moments. Classic music is the best choice because it is so soothing and almost everyone likes it.

  1. Play cards or a board game together

This is a great way to communicate and have fun. Again, playing games is not physically exhausting but definitely brings pleasure. Just choose the game you both prefer and enjoy your time together.

  1. Go for a walk

This one is more physically challenging but is still a great idea. Exercise is essential for having better health. So, spend some time every day for going out together with the one you care for. You need to pay attention when fatigue appears in the elderly person and go home soon.

  1. Make a weekly meal menu

It is quite useful to discuss the menu for the next week. Since you probably prepare or buy the meals, you should choose the ones that take you less money and time. Still, you should ask for the preferences of the elderly person. Otherwise, you will spend time and money on something that he or she will not eat.

  1. Water the plants at home

Even when you are sick and old, it is quite satisfying to take care for someone or something else. That is why many elderly people like having plants at home. Water the plants together to make sure that they will survive.

  1. Have a picnic or afternoon tea

These are great ideas because they both involve some preparation, as well as spending some time together. Make the tea or the meals for the picnic together. Then have some pleasure time at home or outdoors but close to home. If you have a picnic outdoors, you might even have a little nap on a blanket afterwards in the fresh air.

The following two activities you should perform by yourself as a caregiver. They will ensure more safety at home.

  1. Install a medical alert system

Medical Alert systems are designed to send emergency alarms and summon emergency medical personnel when a medical emergency take place. Usually these systems come with a wireless transmitter that could be activated in the event of an emergency. In case of a medical emergency, such a system might be essential.

  1. Tidy up the house

Make sure that you get rid of all that might be dangerous or just is unnecessary. There should be nothing on the floor that makes walking more difficult. Also, make sure that there is nothing heavy that might fall down. After all, elderly people rarely need a lot of stuff, so just throw away or put in the garage everything that is not really necessary.