Congratulations to Audrey Pounds for being chosen for HCSS OF THE YEAR!



Audrey was chosen because she has shown that she is willing to “Go the Extra Mile,” and has shown her clients that she is compassionate, dependable, and an outstanding team player. 



Audrey reported that what she likes most about working for New Beginnings is that the Agency makes her feel appreciated for doing her job.  Audrey reported that she feels that she has learned to be more patient working in this filed.  Audrey stated that she has also worked as a Medical Assistant, and a CNY, and has had many hats in the medical field.



Audrey has one son, who is four years old, who she reported spends all of her spare time with.  She stated that they enjoy going to the library together, and riding the carousal at Destiny Mall.  Audrey lastly stated that she loves her job, and never felt more welcome or more comfortable at her work.  Audrey stated that she doesn’t even feel like she is working because she enjoys it.


Thank you for all of your hard work and dedication to this Agency, Audrey!  We are lucky to have you on our team!

10 Questions to Ask Before Hiring a Caregiver or Home Care Agency!

In a recent study, it was shown that:

  • Only 55 percent of the Home Care Agencies did a federal background check. 
  • Only one-third of the agencies test for caregiver skill competency.
  • Supervision ranged from non to weekly, and included home visits, telephone calls, and caregivers visiting the office.

By being an educated consumer, you can find a qualified, reputable agency that employees caregivers who will care for your parent with compassion and skill. 

 Here are ten questions to ask before you hire a caregiver.

  1. Go through a well known agency.  This doesn't necessarily mean a large franchise, but get references before choosing.
  2. What recruiting methods do they use? How are they finding job candidates? Newspaper ads? Staff agencies? Craigslist?
  3. What are their hiring requirements for prospective employees?
  4. What screenings are preformed on caregivers before they are hired? Criminal background checks-federal or state?
  5. How does the agency assess what the caregiver is capable of doing?
  6. Does the agency train caregivers? What does the training entail? Are they knowledgeable about elderly health conditions?
  7. Are the caregivers insured and bonded through the agency?
  8. IS the agency diligent about sending the same caregiver to their home, rather than a revolving door of strangers who parents don’t know or trust?
  9. If you are not satisfied with a particular caregiver, will the agency provide a different person?
  10. Does the agency provide a supervisor to evaluate the quality of home care on a regular basis?  How frequently?

These ten questions will provide you with a great start to getting into the type of care and response that you will receive with the agency that you are questioning. 

Sleep Disruption with TBI's

Many people who have brain injuries suffer from sleep disturbances.  Sleep is a complex process that involves many parts of the brain.  The brain directs sleep by putting your body to rest.  When you injure your brain, it can lead to many changes in sleep.  For this reason, and depending on the location and the extent of the injury, many different kinds of sleep disturbances can occur after a brain injury.  Not sleeping well can increase or worsen depression, anxiety, fatigue, irritability, and one’s sense of well-being.  It can also lead to poor work performance and traffic or workplace accidents.  A review of sleep disorders studies and surveys revealed that a sleep disorder is three times more coming in TBI patients than in the general population.  Women are more likely to be affected, as are the elderly. 

Some common sleep disorders include:

Insomnia-difficulty with falling asleep or staying asleep or sleep that does not make you feel rested.  Insomnia can worsen other problems resulting from brain injuries, including behavioral and cognitive difficulties.  Insomnia makes it harder to learn new things, and is typically worse directly after injury, and often improves as time passes.   

Excessive Daytime Sleepiness.

Delayed Sleep Phase Syndrome-Mixed up sleeping patterns.

Narcolepsy- Falling asleep suddenly and uncontrollably during the day.

Common sleep syndromes include:

Restless Leg Syndrome (RLS): Urge to move the legs because they feel comfortable, especially at night or when lying down. 

Bruxism: Grinding or clenching teeth.

Sleep Apnea: Brief pauses in breathing during sleep, resulting in reduced oxygen flow to the brain and causing loud snoring and frequent awakening.

Periodic limb movement disorder (PLMD): Involuntary movement of legs and arms during sleep. 

Sleepwalking: Walking or performing other activities while sleeping and not being aware of it.

Things You Can Do to Improve Sleep:

Set an alarm to try to wake up at the same time every day.

Include meaningful activities in your daily schedule.

Get off the couch and limit TV watching

Exercise every day.

Try to get outdoor for some sunlight during daytime. 

Don’t nap for more than 20 minutes a day.

Go to bed at the same time every night.

Follow a bedtime routing.

Avoid caffeine, nicotine, alcohol, and sugar for five hours before bedtime.

Avoid eating prior to sleep to allow time to digest, but also do not go to bed hungry.

Do not eat, read, or watch TV while in bed.

Keep stress out of the bedroom.  Do not work or pay bills there.

Create a restful atmosphere in the bedroom.

If you don’t fall asleep in 30 minutes, get out of bed and do something relaxing or boring until you feel sleepy.  

Memory Loss... Is it normal, or the beginnings of Alzheimer's?

As people age, it's normal to have occasional memory problems, such as forgetting the name of a person you've recently met. However, Alzheimer's is more than occasional memory loss. It's a disease that causes brain cells to malfunction and ultimately die. When this happens, an individual may forget the name of a longtime friend, or what roads to take to return to a home they've lived in for decades.

It can be difficult to tell normal memory problems from memory problems that should be a cause for concern. The Alzheimer's Association has developed information to help you tell the difference. If you or a loved one has memory problems or other problems with thinking and learning that concern you, contact a physician. Sometimes the problems are caused by medication side effects, vitamin deficiencies or other conditions and can be reversed with treatment. The memory and thinking problems may also be caused by another type of dementia.

We are all forgetful from time to time. Given the growing attention to Alzheimer's in the news these days, many of us, especially senior citizens, have a nagging worry about it. Could it be happening to us? Could we be getting Alzheimer's?

Here are the most often cited list of signs of Alzheimer's Disease as posted from the Alzheimer's Association:

1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

In reading this list, you should consider a couple of things. 

First is that the severity and frequency of a given symptom is important. For example, if a person is an accountant and becomes completely unable to balance the checkbook this may be reason for concern. But occasionally making an error while working on the checkbook is probably not something you should worry about. The second thing is that, as mentioned above, the symptoms of Alzheimer's typically disrupt daily life while signs of normal aging usually do not.

With normal aging, we may forget where we parked at the mall, but with Alzheimer's we may forget how we got to the mall. Forgetting the names of people you rarely see can be normal, while forgetting the names of people close to you can be an early sign of Alzheimer's.
Misplacing things from time to time may be normal. But putting things in very unusual places and accusing others of stealing them could be of concern. I give the following example: If you put your glasses in a desk drawer when you normally put them on the top of the desk, that's one thing. But putting them in the freezer or on a high shelf in the garage or in a suitcase kept in the basement is another altogether.

Here are two circumstances that you might experience that may lead you to contact your doctor. First, if you are experiencing the type of memory issues indicated above as possible signs of Alzheimer's, it would be a good idea to write examples down and take it to a neurologist or family physician. Second, even if you aren't having such memory problems, but you're still overly worried about your memory, it might be worth a trip to the doctor. In the very least, it will ease your mind of worries that may turn out to be nothing!

New Rules for Veterans Disability Related to TBI's

Thousands of service members returning home from Iraq and Afghanistan suffer from traumatic brain injury (TBI). So many, in fact, that TBI is called the “signature injury” of these wars. This has been attributed in part to the common use of roadside bombs (IEDs), fire bombs, and other explosives by insurgents.

Traumatic brain injury is characterized by both physical and psychological impairments, and oftentimes, veterans suffer from residual effects of TBI. In those cases, the VA may not recognize those residual symptoms as being caused by traumatic brain injury, and this creates a limitation on the benefits a veteran can receive.

Because the Department of Veterans Affairs (VA) has been criticized for underestimating the effects of TBI and not awarding benefits to many veterans suffering from TBI, the VA has proposed a revised regulation, 38 CFR 3.310, to help more veterans with TBI to qualify for benefits.

The proposed rule recognizes five illnesses as being caused or worsened by TBI. A veteran who can establish service-connection for traumatic brain injury (that is, that the TBI resulted from military service) may be able to get an increase in benefits based on these illnesses once the new rule is finalized.

After the proposed rule becomes final, the following diseases will be presumed to be service-connected:

  • Parkinson’s disease that is diagnosed following moderate or severe TBI
  • seizures for which no cause has been established following moderate or severe TBI
  • certain dementias if diagnosed within 15 years after moderate or severe TBI
  • depression that is diagnosed either:


    • within three years of moderate or severe TBI, or
    • within one year of mild TBI
  • hormone deficiency diseases that are diagnosed within 12 months of a diagnosis of moderate to severe TBI.

The VA will use the following evidence to rate TBI as mild, moderate, or severe:

  • MRI, PET, or other scans
  • length of an altered mental state or altered state of consciousness
  • length of loss of consciousness
  • length of amnesia, and
  • score on the Glasgow Coma Scale (a test used after head injuries).
When the VA presumes that a condition is service-connected, this means the veteran does not have to prove that the illness or injury was caused while they were in service. Medical evidence won’t be needed because the VA decides that the mere existence of the disease or medical condition is enough to establish service connection. This is much easier than having to submit evidence to prove the disability was caused during service.
Veterans who would like to be evaluated for TBI, brain injuries, and illnesses resulting from TBI may be eligible for a Gulf War Registry Exam. This is a free exam that does not require enrollment in the VA health care system. Veterans are eligible for this exam if they served during 1990-1991 in Operation Desert Storm, Operation Iraqi Freedom, Operation New Dawn, Operation Desert Shield, or the Gulf War. To ask for the Gulf War Registry Exam, call the Environmental Health Coordinator at your local VA medical center or clinic.

Traveling with a Person who has Disabilities

If you like to travel, but worry about leaving a loved one at home who has a disability, consider taking them with you!  Think of the experience that you and your loved one will be able enjoy and remember!  Here are some tips to traveling with a person who has disabilities:

One thing is to research how easy the city can be to navigate, and how accommodating the city is to wheelchair accessibility.  If you do an internet search of the city's name, and "navigating with special needs," you will be able to find out if this city is an option for you! It will tell you about the sidewalk conditions, and the quality of public transportation, and options for taxi services. If the city has bad public transportation, look into driving services that may be available. 

Look for hotels that will help accommodate your needs, and are close to the sights that you would like to see. Think about things that make your loved one feel comfortable, such as air conditioning.  This will make your trip go more smoothly if the comforts and familiarity that they are used to are also offered at the hotel that you are staying at.  

Consider flying to make your trip shorter.  The airports provide wheelchairs, and offer assistance on and off the plane, and to your next gate, all free of charge.  They also allow you more boarding time so that your loved one can get settled in to their seat without feeling rushed. This will help you avoid long car rides, and you will be able to enjoy your stay at your destination for a longer period of time! 

When getting off of the plane, look into having a car to wait for you.  They will help with your luggage, and you will avoid all of the hassle of trying to hail a taxi.  This will make the trip less stressful, and more relaxing. Take lots of breaks while you are site seeing. Traveling is exhausting, and you don't want to wear your loved one out early on in the trip.  Make time for naps and relaxation!

Make sure to keep any medication on you!  You don't want them to be in your luggage if it gets lost, or delayed.  Carry them in the original bottles, and write down the generic names, just in case you need to find a quick replacement.  If you are traveling outside of the country, write down the interpretation for the reasoning to the medication, such as "high blood pressure." Also look up how to say the things they are allergic to.  

Make sure that you always carry your loved one's doctor's phone number.  A couple of good things to keep on hand at all times are water (to keep hydrated), energy bars and almonds (For a quick boost), Advil, Neosporin, and anti-diarrhea medication.  

Helpful Tips for People with TBI's to Maintain Independence

People who get their TBI later in life, often feel that their independence has been taken away.  Here are some helpful tips to help you maintain some of that independence!


To address problems with memory, attention span, and organization:

Try creating daily schedules and checking things off as you do them. 

Use alarms to remind yourself of things you need to do throughout the day, such as taking medications.  Keep calendars where they are easy to see, and review and update them every day.

Have specific places for things that you use a lot, such as your house keys. 

If reading is challenging, listen to recorded books from the local library.

Play games that use memory and problem solving skills, such as cards, dominoes, checkers, chess, word search puzzles, and board games. 

Reduce distractions such as noise and clutter to help make you concentrate and make fewer mistakes. 


If you want to feel more in control of your emotions and behavior:

Try to avoid things that make you angry or frustrated.

Make time to do the things you enjoy, such as hobbies or being with friends.

Allow yourself to grieve your losses.

Accept help from people you trust.

Get enough sleep and rest.  Being tired and in pain can make it harder to cope.

Join a support group to share your experiences and learn from others.


To ensure that you are being as safe as possible:

Keep emergency contact numbers on the refrigerator, where they are easy to find, and see. 

Remember that you may need more help than you realize.  Ask for support from a family member or friend. 

Use household appliances that have fewer risks until you have been evaluated.  For example, use the microwave instead of a stove.

If you want to drive, have an evaluation before getting behind the wheel.  If you can’t drive, look into an alternative transportation in your community.

Install safety grab bars near the toilet, and in the tub if you have poor strength and balance. 

Look into some sort of an emergency call button so that you are able to call for help if need be.

If you would like to get back into participating in work, school, or volunteer opportunities:

Think about things you enjoy and are good at.  How can you apply these to work, school, or volunteer positions?

Meet with your employer or school administrator to talk about your skills, and what you need help with.

Consider taking a different job in the same company if you are having trouble at work.

Ask for feedback or assistance from a trusted friend or colleague.   

Summer Heat Safety Tips

Summer Heat can be dangerous-even deadly- if you don't take the proper precautions.  Everyone should take the proper precautions

Everyone should follow these basic heat safety tips in order to avoid the dangers of heat exposure. Keep these suggestions in mind:

  •  During the hottest hours of the day, stay inside.  If possible, stay inside an air-conditioned building.  These hours are typically from mid morning, until mid afternoon.
  • Dress lightly, and when sleeping, use lightweight, breathable covers.
  • Drink plenty of water and other fluids.  When temperatures climb above 90 degrees, it is important to drink at least a gallon of liquid per day.  Those who are overweight need more. 
  • Avoid drinking alcoholic beverages, or beverages that are carbonated or contain caffeine when temperatures are high, as they can lead to dehydration. 
  • Keep blinds and curtains closed from morning until late afternoon to block extra direct heat from sunlight.
  • Move your exercise routine to early morning or later in the evening.
  • Never ever leave a person or a pet in the car in hot conditions while you run  to do a quick errand. 
  • Seek medical care right away if you become nauseous, start vomiting, or experience cramps. 
  • Stay on the lowest level of your home. 
  • Use a fan.  Don’t place the fan in front of the window because it will push in hot air. 
  • Use small appliances like slow cookers and tabletop grills rather than traditional oven or stove to keep kitchen heat to a minimum. 
  • If you know an elderly person might be exposed to the heat, try to visit them twice a day if it is extremely hot.

Help your elderly person get to know their neighbors so they are not so isolated. 

  • Signs of Heat Exhaustion
  • Breathing that is shallow and fast.
  • Clammy skin
  • Dizziness
  • Dry mouth
  • Excessive sweating
  • Fainting
  • Headache
  • Loss of color in skin
  • Nausea
  • Pale Complexion
  • Pulse that is fast and weak

Understanding an Individual with a TBI

A brain injury occurs every 23 seconds.  3.1 Million Americans live with a Brain Injury.  Obtaining knowledge of Traumatic Brain Injuries will help you understand a client or family member who has one and it will improve the quality of services that you provide to individuals with brain injuries. 

The brain controls everything that we do.  Breathing, walking, talking, thinking, behaving, and feeling are all connected to the brain. Damage to the brain may vary in extent, area, and type of damage, depending on a variety of factors relating to the nature of the injury, the severity of the injury, how the injury occurred, and the quickness of medical response.  Brain Damage occurs in a TBI in 3 different areas.  The Focal Damage would pertain to damages such as skull fractures, contusions or bruises under the location of a particular area of impact.  The Fronto-Temporal Contusions/Lacerations refers to the bruising of the brain, or tearing of blood vessels in the frontal and temporal lobes of the brain caused by the brain hitting or rotating across the ridges inside the skull.  The Diffuse Anoxal Injury refers to when the shifting and rotation of the brain inside the skull will result in tearing and shearing injuries to the brain’s long connecting nerve fibers or axons.  If the brain damage is from a medical incident that results in an infection, swelling of the brain or anoxia, the damage tends to be more diffused.  If the brain damage is related to a medical incident like a stroke or aneurysm, the damage tends to be more focal.

Every person with a brain injury is vastly different because every individual is different prior to an injury, and all brain injuries are different within themselves.  Damage to the brain may vary in extent, area, and type of damage depending on a variety of factors relating to the nature of the injury, the severity of the injury, how the injury occurred, and the quickness of medical responses, among other factors.  Every person adjusts differently to the changes that result from brain injury. Therefore, every person with a brain injury needs differing types and levels of support.  The results of brain injuries can be categorized into the following areas:   Physical, Cognitive, Executive Functioning, Affective Behavioral, and Psychosocial.    

Since every person is different, it is very important to get to know your family member’s or client’s abilities.  A good acronym to remember for this is ROAD.  This stands for Read/Review, Observe, Ask questions, Don’t assume.  ROAD will help to support an individual with a brain injury. 

There are some things to keep in mind and remember while you are with an individual with a Traumatic Brain Injury.  Remember to stress the individual’s strength’s.  Be honest, but gentle and tactful when helping them.  Don’t take things personally; people with brain injuries tend to not have a filter.  Treat everyone with dignity and respect, and never talk down to this person.  Avoid arguments and blame.  Respect differences, and understand you’re own and the person’s cultural and personal values.  Remember that progress may be slow, but keep at it-it works!!  Lastly, make sure you give yourself a pat on the back for a job well done! 

Ways to Prevent Falls-Be Proactive!

Falls are a common occurrence with Seniors.  A study done among Seniors found that preventing falls, and the resulting injuries from these falls, can reduce or delay the need to move to a long-term care facility.  In fact, falls are the leading cause of injury death among older adults.  Here are a few tips to help you gain confidence to maintain your independence.  

Health and age related changes often attribute to falls.  Some of these include problems with balance, slow reflexes, poor eyesight, and use of certain medication.  If you are aware of these changes occurring, make sure that you take precautions while being mobile.  

Dangerous situation in the homes also attribute to falls.  To prevent this from happening, assess your living situation and take proactive measures to ensure your safety.  Some things to be aware of in your home are slippery floors, poor lighting, electrical cords in pathways, loose rugs, raised thresholds, and clutter.  Try these tips to help make the inside of your home safe:

Remove all extraneous clutter in your home.  Keep telephone and electrical cords out of pathways.  Tack rugs and glue vinyl flooring so they lie flat.  Remove or replace rugs or runners that tend to slip or attach non-slip backing.  Do not stand on chairs to reach for things.  Store frequently used items where you can conveniently reach them.  Keep a well-lit home, inside and out!  Use nightlights and keep flashlights handy. Install handrails on both sides of the stairs to keep you steady.   

In your bathroom, add grab bars in the shower, tub, and toilet area.  Use non-slip adhesive strips inside the shower or tub.  Consider getting a stool or bench to use in the shower.  

For outside of your home, paint the outdoor steps with a mixture of sand and paint for better traction.  Keep outdoor walkways clear, and well-lit.  Make sure snow and ice are kept clear from entrances and sidewalks.  

We hope that these tips have been useful in making your home as safe as possible for you.  Our ultimate goal is to keep people safely in their homes, and help them maintain their independence as long as possible!

A good example of the way to maintain                                                  A bad example of how to maintain                a room                                                                                                           a room.                                                                                                                       


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