Merrily Orsini

Caring.com Expert

About

Merrily Orsini was a pioneer in the business of providing geriatric care and managed in-home care. She currently serves on the advisory board of the Private Duty Homecare Association, an arm of the National Association of Home Care and Hospice. She has a master's degree in social work and is a nationally known writer and speaker on aging, elder issues, and in-home care. She served on the board of the National Association of Professional Geriatric Care Managers, chaired two national conferences presented in conjunction with the National Academy of Elder Law Attorneys, was a delegate to the National Institute on Aging, and cofounded and co-owned a company that provided in-home care to frail elders from 1981 to 1998.

While working in in-home care, Orsini recognized a need for special training for those who provided care at home, so she created a state-licensed, certified elder-caregiver program. She also developed a training system to help caregivers better learn how to work with clients with Alzheimer's disease or related dementias. Her agency provided a unique model of care that used geriatric care management in conjunction with in-home care to allow frail elders to remain at home as long as they desired to do so.

Recently Published on Caring.com

  1. Friday October 30, 2009

    1. What are the "do's and don'ts" of home care under Medicaid?

      Answer - Unfortunately the question does not have a simple answer. If you are referring to the qualifications and competencies of personal care workers under Medicaid, federal law leaves most of that up to the individual states to determine. And the services provided are confusing, but relative to the scope of...

  2. Wednesday October 14, 2009

    1. Do I need to get a new home health aide license if I've moved?

      Answer - To inquire about a home health license in California I would start by contacting CAHSAH and see if they can direct you to the correct agency that can answer your question.

  3. Friday October 09, 2009

    1. How can we keep my father-in-law from being so lethargic?

      Answer - You mention that your father-in-law is most content when watching movies. The key to caring for someone with Alzheimer’s is to keep them content and avoid confrontation. Two things that bother me about his movie hobby are the sitting in one place for a long time, and the potential safety issue of his being alone without any supervision...

  4. Tuesday September 29, 2009

    1. What happens if in-home care workers do not pay taxes?

      Answer - This is a difficult topic, paying taxes for in-home care workers, and one that full employment home care agencies fight in many ways. In Florida the state association for home care even supports this registry model. In California there is a classification for domestic referral agencies that is condoned by the state as well...

  5. Friday September 04, 2009

    1. Is mom's caregiver taking advantage?

      Answer - There are several red flags in your question. First, is that this caregiver may be privately hired, since if the caregiver is from an agency, then it is the agency’s responsibility to deal with the caregiver, and not yours. Since it sounds as if this may be a privately hired caregiver, and if...

  6. Tuesday August 25, 2009

    1. Does long term care insurance cover the costs of a certified nurse aide (CNA)?

      Answer - First, check with your LTCi agent to make certain that you pay directly to the aide and be reimbursed, and not through an agency. Each policy is different as to what constitutes the event that triggers coverage, and what is covered and by whom. Your agent is the best one to cover this with you...

  7. Sunday August 23, 2009

    1. What is the benefit of getting a home health aid license?

      Answer - State licensures as well as state home health aid license regulations vary by state, as do payments for state funded programs.I suggest you contact your state licensure department and get these questions answered.If you have trouble finding a contact, try the state home health association to see if they can assist...

    2. Can I get help to pay for a caregiver?

      Answer - Most states have programs that assist income eligible people who need household assistance to keep out of a nursing home. These programs pay for a caregiver, if you are eligible. I suggest you contact your Area Agency on Aging or your county human services office and see if you can get a case manager assigned to come and assess you for assistance in the home...

  8. Wednesday June 17, 2009

    1. How do I find more affordable home care?

      Answer - What a complicated issue! Having trouble finding affordable in-home care seems to be an issue for you as well as the government. The issue is that pay is commensurate with getting a trained, kind and loving person to come to your home to perform a simple task...

  9. Saturday May 30, 2009

    1. How do I change hospice agencies?

      Answer - A red flag appears when I hear about an ill person distrusting those whose job is to provide care and comfort. Medicine interactions, cognitive impairments related to the disease process-both of these things can make a person distrustful when there is no reason to be distrustful...

  10. Monday May 04, 2009

    1. Do home health care aides commonly charge for travel expenses?

      Answer - Home health aides are paid by the hour or by the visit. When a patient or client lives a distance away from the agency, or from a major metropolitan area where there is adequate public transportation, it is common to charge either a set fee for travel within a certain radius or to charge actual mileage, which is based on the IRS reimbursed rate of $...

  11. Saturday April 11, 2009

    1. How can I best support my husband who sometimes seems in denial that his mother is dying?

      Answer - Get your husband to talk with Hospice, and get a counselor. One of the roles of Hospice is to counsel and provide assistance to those who are having trouble understanding the finality and accepting that this is the end of life for a loved one...

  12. Thursday February 12, 2009

    1. My mother believes she is talking to the dead. Should I be concerned?

      Answer - Hallucinating is one symptom or bi-product of some cognitive disorders. You mention that your mother has Alzheimer's, and, I assume that is a diagnosis received from a geriatric specialist and not a self diagnosis based on confusion or behavior. If you have not had her screened and properly diagnosed, do so immediately...

  13. Tuesday January 13, 2009

    1. How can I help my mother with the stress of caring for my grandmother?

      Answer - How to find respite care and other supports for stressed caregivers of elderly parents.

  14. Friday November 07, 2008

    1. I am a home health care aide. Where are the best resources to find jobs?

      Answer - Resources for jobs for home health care aides. Where to go to find a job as a home health care aide.

  15. Wednesday July 30, 2008

    1. What social services for widow of veteran are available? Does it include home health care?

      Answer - How to find acceptable home health aides for elderly parents or seniors on Medicare or Medicaid.

  16. Tuesday May 20, 2008

    1. Do you have any tips for moving my parente out of a nursing home back to a home?

      Answer - How to create a discharge plan when an aging relative is ready to leave a nursing home.

  17. Thursday May 15, 2008

    1. How Can I Convince my Brother Not to Leave His Nursing Home?

      Answer - Many of our readers are struggling with this same issue -- believing we know what is best for a loved one but being unable to get that loved one to see things the same way. The bottom line is, your brother is an adult and can make his own decisions...

  18. Monday March 31, 2008

    1. How can we convince my father, who has cancer and can not live alone but insists, to move in with us?

      Answer - When ailing, elderly parents refuse to move, here are suggestions for finding supports in their community.

  19. Monday February 11, 2008

    1. How can I help my parents with dementia accept the care they need?

      Answer - The operative word in this question is "dementia." A person who suffers from dementia does not have the same reasoning capabilities that he or she once had. If your parents are suffering from dementia, they are not able to process information, or understand cause and effect...

    2. How can we convince my in-laws that they need alternative housing?

      Answer - Moving from a family home is an overwhelming prospect for an elderly couple. Add on the physical and emotional burdens your in-laws are experiencing and it probably feels like an impossible challenge. But the care needs you are describing are only going to increase over time.