Home Aquarium Fish Tanks and Alzheimer’s dementia

An interesting new therapy concept shared by Deirdre E. via LinkedIn

When I was much younger with young children of my own, I ran a daycare center for working Moms. One two-year-old little boy was particularly precocious and spent many long minutes in front of our home Aquarium fish tank.

If anything got spilled, broken or turned over– it was usually Jack who got the “time-out” which meant 4 minutes in front of our home fish aquarium.

He wasn’t a naughty boy but slow to talk, and even slower to accept the rules of the house.

Our large fish tank was filled with colorful fish and shells and air bubbles and lots of other activity most of the time. A few minutes in front of the Fish Tank was little punishment for the small children I babysat, yet it calmed them down and soothed their tears if they were upset.

So recently I was not surprised to learn that a Fish Aquarium can do the same for those with Alzheimer’s dementia.

Researchers at Purdue University have found that displaying tanks of brightly colored fish may curtail disruptive behaviors and improve eating habits of people with the disease of Alzheimer’s dementia.

Folks with Alzheimer’s react calmly to most house pets such as dogs or cats and now it seems that a fish aquarium can offer the same calming affect for those with Alzheimer’s dementia too.

If you have no time to care for a dog or cat or other pet, yet have someone with Alzheimer’s in your home, an aquarium with lots of fish and activity may be just what you need.

A fish aquarium is alive with color. Besides the fish, the decorations are colorful and offer a soothing affect as water flows and bubbles float. A beautiful fish tank with many colors and flora is as fascinating for adults as it is for children.

It can bring a sense of peace and quiet. It can calm an angry person to settle down and watch the quiet and peacefulness of life inside the aquarium.

A local nursing home that has a large aquarium for their residents says, “It gives the residents meaning and purpose on a daily basis.”

I remember my own Mom could sit and watch the fish for hours, usually laughing and smiling and talking to them.

If you have someone in your home with Alzheimer’s dementia who suffers from agitation and is difficult to calm, try adding a Fish aquarium to your home with a comfortable chair nearby.

My mom loved the fish aquarium and could watch it for hours, tapping the side and talking to the fish inside. It is an excellent way to end mood swings for the person with dementia.

Aquariums come in all sizes. Extra large tanks, such as this one, which can be recessed into the wall and makes a stunning presentation for the gorgeous fish that are available nowadays.

Yet a moderate size fish tank is just as satisfying for the person with Alzheimer’s dementia.

The attraction is the fish and all the activity happening in the tank.

Yet a moderate size fish tank is just as satisfying for the person with Alzheimer’s dementia. Their fascination is with the fish and activity inside the tank.

Two Mothers Remembered – A poem for all touched by Dimentia

I love this beautiful poem by Joann Snow Duncanson.

It’s at once tender and loving, sad and joyful, grateful and hopeful.  Mothers and daughters worldwide who live with dementia every day know the truth in these words captured so eloquently in just six stanzas.

Thank you Joann Snow Duncanson, for living the journey with your mother and for sharing it with us in this beautiful piece of poetry.

Two Mothers Remembered

by Joann Snow Duncanson

I had two mothers – two mothers I claim,
two different people, yet with the same name.
Two separate women, diverse by design,
but I loved them both because they were mine.

The first was the mother who carried me here,
gave birth and nurtured and launch my career.
She was the one whose features I bear,
complete with the facial expressions I wear.

She gave her love, which follows me yet,
along with examples in life that she set.
As I got older, she somehow younger grew,
and we’d laugh as just mothers and daughters do.

But then came the time that her mind clouded so,
and I sensed that the mother I knew would soon go.
So quickly she changed and turned into the other,
a stranger dressed in the clothes of my mother.

Oh, she looked the same, at least at arms length,
but now she was the child and I was her strength.
We’d come full circle, we women three,
my mother the first, the second and me.

And if my own children should come to a day,
when a new mother comes and the old goes away,
I’d ask of them nothing that I didn’t do.
Love both of your mothers as both have loved you.

The Core is the Core


Thank you for sharing this info, Dr. Michael Hurst of Hurst Chiropractic in Encino

Whether the topic is education or exercise, core content and core activities tie everything together. In education, core content includes the specific information upon which the course is based. Students are expected, at the very least, to demonstrate mastery of the core content. In exercise, core activities establish the musculoskeletal foundation that supports and enables all other components of physical fitness, including strength training, cardiorespiratory exercise, and sports readiness.

The term “core” in core exercise is relatively new, but athletes and other persons participating in physical fitness activities have been doing core routines since at least the time of the ancient Greeks, more than 2500 years ago. For example, wrestling, the ancient Greeks’ most popular organized sport, is grounded in core stability and strength. More recently, in the 1930s, 1940s, and 1950s, high school “phys ed” classes emphasized squat thrusts, jumping jacks, pushups, pullups, and abdominal strengthening. Thus, before the advent of today’s ubiquitous fitness centers and the plethora of personal trainers teaching members how to do an abdominal curl-up on a physioball, core exercises were part of the regular curriculum of all public school students in ninth grade and beyond. Core exercise is not new, but the need for core training became lost in the 1980s fitness boom that focused on “aerobics” and “cardio”, and secondarily on strength training.

The importance of core training and the need to learn core exercises has undergone a resurgence recently, as the quantity and frequency of exercise-related injuries has skyrocketed. People eager to make healthier lifestyle choices, including those anxious to lose weight, have thronged their local fitness centers. But although it seems simple and straightforward to pedal an exercise bike, lope up and down on an elliptical stair-stepper, lift a dumbbell, or press down or pull up on a machine-assisted exercise bar, if the exerciser’s core muscles are deconditioned, injury is the likely result, sooner or later.1,2

The most important core muscle is the transversus abdominis, a sheet of horizontally oriented muscle fibers that lies beneath the more familiar abdominal muscles, that is, the rectus abdominis, internal obliques, and external obliques.3 Core muscles include the mutifidi and rotatores, small, deep spinal muscles that connect and help move pairs and groups of spinal vertebras, and other back muscles such as the erector spinae and longissimus thoracis. Everyone needs to train the core as a primary component of an ongoing program of regular, vigorous exercise. There are innumerable highly effective core exercises and most do not require any equipment. A physioball provides the opportunity for variety and increasing levels of difficulty. Such accessories are low cost and usually available in local fitness centers. As with all forms of exercise, start slow and build strength and endurance gradually. It doesn’t take long to notice the benefits of a regular core routine, including enhanced spinal flexibility, improved balance, and a flatter abdominal region.

1Chang WD, et al: Core strength training for patients with chronic low back pain. J Phys Ther Sci 27(3):619-22, 2015
2Southwell DJ1, et al: The acute effects of targeted abdominal muscle activation training on spine stability and neuromuscular control. J Neuroeng Rehabil 13(1):19, 2016
3Leonard JH, et al: Changes in Transversus Abdominis Muscle Thickness after Lumbo-Pelvic Core Stabilization Training among Chronic Low Back Pain Individuals. Clin Ther 2015;166(5):e312-6. doi: 10.7417/T.2015.1884

Natural Care In Families Is The Key To Our Survival

AAA Nursing Services is sharing this piece from

The Caregiver’s Living Room, A Blog By Donna Thomson


This is a sponsored post written by me on behalf of Elizz. All opinions are 100% mine.
The natural, loving care that family members provide to one another is the engine of society.  The care we give to those we love makes all other work possible and is the key to our very survival individually and collectively.
What exactly IS this care and how does it play out in families?
A mother arrives home from the hospital, newborn baby boy in her arms.  Family and friends arrive with casseroles and plates of sandwiches.  In a while, a friend invites the older children outside for a ball game.  The new father smiles and whispers to his wife, “I will look after everything… you go and lie down with the baby.  I’ll bring you some tea.”
Everyone understands that building the bond between mother and baby is sacred, especially in the first days and weeks of a new life.  Everyone understands that the mother’s most urgent task is to bond with and care for her baby without distraction.
Years later, the same mother stumbles and falls.  She has broken her hip.  Her husband has passed away and all the children, except one, have moved to find work in cities far away.  Her youngest son, the baby she nursed so long ago, lives nearby.  He is his mother’s caregiver.
Older brothers and sisters telephone and write, asking for daily updates. They use technology and time saving apps to plan a schedule of rotating visits in order to support their mother and their brother in his caring role. They arrange for food to be delivered, the house to be cleaned and for neighbours to drop in for the sake of helpful friendship.  They do this so their brother can give care to their mother without distraction.
‘I care for you because you cared for me’ represents the ethic of reciprocity that children of the frail elderly cite as an important motivation for caregiving and how Elizz changes lives every day.  When caregivers decide to devote time, energy and kindness to an elderly parent, they have made a moral decision about what is right under the circumstances.  And that moral decision is one that is rooted in love.  Parents of children with disabilities or spouses of people with chronic illness make this decision, too.
There is a saying “You can’t pour from an empty cup.  Fill yourself up first so you can then overflow.”   When we see someone giving care, we pour in her cup.  And the pouring and overflowing repeats itself in every family, in every culture.

A nurse by herself. At the end of life.


I softly scrub blood from the teeth of a man who died moments ago. From the chair where I sat quietly writing nursing notes while he quietly ended, my patient’s sallow skin and sunken cheeks looked so peaceful. But the weeks of stagnant residue on his teeth bothered me.

To brush the teeth of someone who was in the process of dying would have contradicted my orders to provide comfort care, and my own good sense. So I waited until he took his last breaths before I closed my computer screen and gathered my tools — washcloth, water, toothbrush.
I brush now, so briefly, for the pride of this man I didn’t know, and I brush for the family that I wish was here to care about him. He does have family — it is they who authorized removing his life support, in keeping with the wishes expressed in his living will. Their brief go-ahead over the phone satisfied their legal obligations, but their absence during his actual passing has left me feeling oddly confused.
As I brush, I think of my role as a seasoned ICU nurse in easing so many deaths — typically so frantic and full, but this time so quiet and empty.

I’m shocked at how strange this particular passing has felt.

Sure, I’ve had solo deaths before: on my first day of nursing, my patient died fifteen minutes after I’d come on duty, the color fading from her pink lips and rosy cheeks before her husband could arrive to see. But this felt different.

It was the first time, I realize, that I’ve given end-of-life care to someone whose family was willing to advocate for his death, but not to attend it.

I missed the cast of characters and unofficial rituals that normally surround the switching off of the life-sustaining medications and the removal of the breathing tube. Where were the nervous mother and the teary uncle, the tissue-box requests and the stale bereavement cookies? What about the clumsy face-shave, given more to console the living than to care for one soon to grow slack and cold?

I missed caring for family members, I realize. I know how to reassure them about agonal breathing: “When the breathing tube is removed, sometimes there are noises.” I’m adept at finding extra chairs and strategically placing tissues. I advocate for extra pain medicine as ferociously as if it were for a member of my own family. This time around, having no one but my comatose patient to tend to, I felt lost.

Without any family, life story or tradition to shape them, his last minutes were governed only by a set of instructions:

1. Administer pain dose once, prior to extubation.
2. Extubate patient.
3. Administer pain dose every three minutes for respiratory rate greater than twenty,
or obvious signs of pain, as needed.
4. Notify house staff at time of asystole.

Before beginning the extubation process, I paused to take a breath. I know exactly how to do this work; the steps are not difficult or new. Carried out with no one else to witness them, though, they felt foreign and frightening. The enormity of my power at this point in this man’s life, compared to my utter absence throughout the rest of it, paralyzed me.

In the face of the heavy silence, I stalled. I combed his hair; I meticulously labeled and color-coded each syringe of medication. I wrestled with the illogic of giving him a clean gown, but did so anyway.

I can’t let him die with tube-feed glop on his shoulder.

The resident popped in, her flinching smile telegraphing that the emergency-room doctors had admitted a patient who was now waiting for this bed: Hurry up! Our eyes met, shared the same sad question — Where’s this man’s family? Then she was gone.

I wanted to keep the man’s death from being just a procedure, but knew nothing of his preferences regarding the last moments of his life.

Nervously, I created a ritual: a bit of quiet, some jazz playing on my cell phone, a moment to note the setting sun.

But the jazz felt presumptuous. What if he hates jazz? I shut it off and stuck to my simple directions, carefully documenting them:

1640 Pre-extubation pain dose given per order.
1645 Extubated per order.
1650 Respirations 26. Post-extubation pain dose given per order.

Some breaths, but not many. Some work, but no pain, my simple, silent assessment.

1720 Asystole.


I called the resident. She came in and made the pronouncement. When she left, I took a few seconds to gather up the toothbrush and cautiously set to work.

Who am I doing this for? I wonder, gently massaging the spit off of the dead man’s front teeth. Am I doing this out of guilt that no one has asked me to do it, or because this is what I do for all of my patients, and without it, my care would seem like euthanasia?

To be sure, my actions have mirrored his wishes. I could do no other: his living will clearly stated that he wanted no heroic measures. But without the usual complement of “nurse-y” tasks, such as consoling the family, I’ve felt too powerful, somehow. It’s a jarring sensation. Now I’m clinging, as family members often cling, to the tiny aspects of life that remain.

His teeth finished, my patient looks better. How odd that death can look better than life.

Still feeling uncomfortable, I move eagerly to the care I know — the preparation of the body after death. I am safe here, with the toe tags and cloth straps and thin plastic pieces. After death takes place, few family members ever ask about these rituals. The actions hold no human presence and are carried out in silence by the nurse:

Remove IVs and carefully dress them. Turn the patient to one side and give the back its last wash. Position a white plastic bag under the remains. Roll the body back in place. Gown the body in clean linens. Tag the great right toe. Zip up the bag and copiously label the outside. Cover the bag with a white sheet over raised side rails to hide the silhouette of death from curious eyes in the hall on the way to the morgue.


The room’s space feels lighter, easier. And now, after hours of rueing the lack of people, I take comfort in being alone. Through the window that I cracked open for myself, I hear a car horn. I notice the pink light of the day ending as the navy night begins.

I turn from my work, unsure who might be pleased by it.

Amanda Anderson is an intensive care nurse. This piece was originally published in Pulse — voices from the heart of medicine.

Image credit: Shutterstock.com

Zeno, Achilles, and the Tortoise

Thank you to Hurst Chiropractic in Encino, CA for this great article.

The Eleatic philosopher Zeno, writing almost 2500 years ago, famously propounded several paradoxes purportedly proving that various conceptions of the physical universe were false. The most famous of these involves the Greek hero Achilles and a tortoise, stating that if the tortoise started ahead of Achilles in a race, the fleet-footed Achaean warrior could never catch the plodding turtle. Zeno also claimed to prove that a moving arrow is actually at rest. His main purpose was to defend the philosophy of the “one” of his great teacher, Parmenides, as against the “many” of competing philosophies such as those of Empedocles, Anaxagoras, and Democritus. Parmenides wished to demonstrate that reality is a unity, and that the world as interpreted by the senses is unreal. Zeno’s paradoxes have stumped many thinkers over the ensuing millennia. The main flaw in his brilliant puzzles is that he blurred the distinction between “discrete” and “continuous” phenomena. We can put the solutions to Zeno’s paradoxes to work in our understanding of the best method by which to approach our philosophy of exercise.

Many of us prevent ourselves from beginning an exercise program by focusing on the daunting perspective of the necessity of doing exercise for one’s entire life. We allow the enormity of the ongoing, continuous nature of such an enterprise to deflate our resolve. The result of this flawed point of view is that we stop ourselves before we can even get started. But if we radically modify our interpretation of the “continuous” nature of the work to be done and instead approach our exercise activities from the “discrete” standpoint, we would then be able to take each exercise session on its own merits. Whole and complete in itself, today’s exercise only needs to be done today. Tomorrow’s exercise, which when it arrives is now “today’s” exercise, is done similarly. Do today’s work today. Over time, the discrete method results in a continuum of results. We accomplish our long-term goals step-by-step, giving our full attention, focus, and concentration to what needs to be done right now, today.1,2

Once we become willing to take on this deeper understanding of the nature of the process of exercise, the next step is to investigate and choose our preferred types of exercise activities. The good news is that, other than making sure we’re doing both cardiovascular and strength training exercises, the specific type of exercise doesn’t matter. As long as we’re doing some form of cardiovascular exercise on a regular basis, whether we run, walk, swim, bike, or cross-country ski is up to us. Similarly, as long as we’re doing some form of strength training on a regular basis, whether we use kettle bells, medicine balls, or a combination of free weights and stationary equipment is our choice. The key, overall, is to avoid Zeno’s critical error, and be well aware of the distinction between “discrete” and “continuous” events. This empowering distinction will be of value, not only in terms of exercise, but in all aspects of life.3

1 Innes KE, Selfe TK: Yoga for Adults with Type 2 Diabetes: A Systematic Review of Controlled Trials. J Diabetes Res 2016;2016:6979370. doi: 10.1155/2016/6979370. Epub 2015 Dec 14.

2 Skórkowska-Telichowska K, et al: Nordic walking in the second half of life. Aging Clin Exp Res 2016 Jan 23. [Epub ahead of print]

3 Haider T, et al: Yoga as an Alternative and Complementary Therapy for Cardiovascular Disease: A Systematic Review. J Evid Based Complementary Altern Med 2016 Jan 19. pii: 2156587215627390.

It’s Not “Mission Impossible”

Forming a new habit and tweaking your mentality about the tasks at hand can have such a positive impact on your life and the goals you want to achieve. Here’s a fantastic article shared from our friends at Hurst Chiropractic in Encino, CA.

Everyone knows what he or she “should” do to obtain good health. But the mere knowledge of what we should be doing is never enough. If we’ve not been in good shape for some time, if we can’t remember the last time we did any meaningful exercise on a consistent basis, and if we’ve added more pounds over the years than we care to admit, then the task of getting back in shape seems an impossible mission. But like the Mission Impossible team in the fabled television series and the hugely successful film adaptations, we too can turn the task of regaining high levels of fitness into “mission possible”.

The primary requirement for your personal restoration project is establishing a new mindset. No one wants to do what other people think they “should” do. Having your spouse tell you that you should lose weight or having your doctor tell you that you need to do more exercise is never pleasant. These admonitions never really work and only serve to create stressful encounters and interactions. Even though the people close to you have good intentions and want the best for you, they usually don’t realize the willingness to change is never sourced from outside a person. The only way you’re going to take on the time and effort of implementing new lifestyle activities is if you yourself choose to do so. Making the active choice to exercise and making the active choice to eat healthy foods will create the powerful difference by which you begin to actually accomplish the action steps necessary to change the quality and characteristics of your health and well-being.1,2

Thus, your own personal choice is what’s required to get you started. Importantly, making such a choice is not a one-time event. Circumstances always intervene and your choice to exercise and eat nutritious foods will need to be reinforced frequently. There may come a time when you choose to sleep late and skip your exercise session for that day. Or you may choose to eat a whole pint of ice cream in the middle of the week. It will be helpful to recall that such deviations from your main plan are always your choice, and returning quickly to your regular exercise routine and regular food program will also be your choice.

None of this needs to be dull, boring, or onerous. Remember that if you think you “have” to do your exercise and “have” to eat fresh fruits and vegetables, then you probably won’t do these things for very long. But if you remind yourself that you have actively made a personal choice to engage in healthy activities, then you will recreate your opportunity for powerfully participating in the ongoing restoration of your own vibrant health and well-being.3

1Sardinha LB, et al: Criterion-referenced fitness standards for predicting physical independence into later life. Exp Gerontol  61:142-146, 2015
2Hafstad AD, et al: How exercise may amend metabolic disturbances in diabetic cardiomyopathy. Antioxid Redox Signal 2015 Mar 4. [Epub ahead of print] 3Crous-Bou M, et al: Mediterranean diet and telomere length in Nurses’ Health Study: population based cohort study. Brit Med J 2014 Dec 2;349:g6674. doi: 10.1136/bmj.g6674

Rice and Beans

The power of real food… article reposted from our friends at Hurst Chiropractic in Encino, CA.

Rice and beans is a well-liked combination of foods that is not only delicious, but also good for you. Other well-known examples of food combinations, such as corn and lima beans (succotash), tomatoes and avocados, and even orange juice and oatmeal, provide benefits beyond those gained by eating these sound nutritional choices individually.1

For example, the combination of rice and beans provides complete dietary protein (containing all the essential amino acids we need to build all the other proteins in our bodies). Similarly, the succotash combination of lima beans and corn contains high concentrations of essential amino acids. When you combine avocados and tomatoes, the fat from the avocado helps your body more efficiently use heart-healthy and cancer-fighting antioxidants such as lycoprene contained in the tomato. A heart-healthy breakfast consisting of real oatmeal, such as oatmeal made from rolled oats or steel cut oats, and real orange juice (not from concentrate) provides a potent combination of phenols that are associated with reduced atherosclerosis and cancer. 2,3

These combinations are specific examples of the more general principle of food combining by which you combine proteins and complex carbohydrates at every meal. When you combine these complementary sources of nutrition on a regular basis, you retrain your body’s metabolism. By consuming a “slow-burning” energy source, you’re providing high-quality fuel for the next three to four hours. Several very good things occur as a result. Energy utilization is optimized, that is, your body gets more benefit out of every calorie it’s burning. Additionally, insulin levels are stabilized throughout the day. Over time, food combining helps a person become a leaner machine and helps reduce the likelihood of developing type 2 diabetes. These benefits are especially important for people who have been told they are hypoglycemic or pre-diabetic. Of course, you should always check with your doctor to make sure a food combining strategy is right for you.

When you add a program of regular, vigorous exercise to your food combining lifestyle choice, you obtain even more profound benefits. The vigorous exercise you’re doing raises your body’s basal metabolic rate. Your body begins to burn calories even when you’re asleep. Owing to the increase in lean muscle mass you’re gaining from exercising over time, you’re burning more calories throughout the day. You find yourself craving more nutritious foods, that is, those that will provide higher-quality nutrition, such as the nutrition contained in such combinations as rice and beans and oatmeal and orange juice. Thus, your positive lifestyle choices contain their own positive feedback system. The better choices you make, the healthier you become, and the healthier you want to be. The long-term results are enhanced health and well being for you, your family, and your friends.

1Liu RH: Health-promoting components of fruits and vegetables in the diet. Adv Nutr 4(3):384S-392S, 2013
2Hu D, et al: Fruits and vegetables consumption and risk of stroke: a meta-analysis of prospective cohort studies. Stroke 45(6):1613-1619, 2014
3Thomburg KL, Challis JR: How to build a healthy heart from scratch. Adv Exp Med Biol 814:205-216, 2014

For information about Home Health services, please visit www.aaanursinginc.com

What AAA Nursing Services is all about

Patient-Centered Care Planning for Home Health

In its landmark 2001 report, Crossing the Quality Chasm, the Institute of Medicine (IOM) named patient-centered care as one of the six fundamental aims of the U.S. health care system.

The IOM defines patient-centered care as:

“Health care that establishes a partnership among practitioners, patients and their families – when appropriate – to ensure that decisions respect patients’wants, needs and preferences and that patients have the education and support they need to make decisions and participate in their own care.”

Patient-centered care planning is the process by which health care professionals and patients discuss, agree and develop an action plan (Care Plan) to provide individualized and coordinated patient care in order to achieve goals/outcomes most relevant to the patient.  Patient-centered care planning is:

  • Process oriented
  • Interdisciplinary
  • Individualized
  • Coordinated
  • Focused on outcomes/goals

This philosophy has been part of our organization’s core mission since it’s inception. We firmly believe that our patient’s, or as we often refer to patients as clients, come first. Home health care can be viewed as quite invasive adding a significant amount of stress to the client and their families. Part of our rehabilitation/care plan not only focuses on positive recovery outcomes but also alleviating any stress factors by including family members in the process.

Decreased patient stress can only have a positive effect on their recovery goals.

You can find more information about us at www.aaanursinginc.com

AAA Nursing Service receives accreditation


AAA Nursing Services awarded CHAP Accreditation

Canoga Park, CA — March 30, 2015 — Community Health Accreditation Partner, Inc., (CHAP) announced today that AAA Nursing Services has been awarded CHAP Accreditation under the CHAP Home Health Standards of Excellence. By achieving CHAP Accreditation, AAA Nursing Services has also been deemed to meet the Medicare Conditions of Participation and is certified as a Medicare provider.

CHAP Accreditation demonstrates that AAA Nursing Services meets the industry’s highest nationally recognized standards. The rigorous evaluation by CHAP focuses on structure and function, quality of services and products, human and financial resources and long term viability. Simply stated, adherence to CHAP’s standards leads to better quality care.

“By achieving CHAP Accreditation, AAA Nursing Services has shown a commitment to excellence,” said Karen Collishaw, CHAP President & CEO. “We are excited to begin our partnership with AAA Nursing Services by offering support in its commitment to providing quality care and continuous improvement.”

AAA Nursing Services provides a variety of Home Health services to patients and their families in Los Angeles and Ventura counties. Home health services may include, but not limited to Skilled Nursing care, Home Health Aide, Physical Therapy, Occupational Therapy and so on.

CHAP is an independent, not-for-profit, accrediting body for community-based health care organizations. Created in 1965, CHAP was the first to recognize the need and value for accreditation in community-based care. CHAP is the oldest national, community-based accrediting body with more than 9,000 agencies currently accredited nationwide. Through “deeming authority” granted by the Centers for Medicare and Medicaid Services (CMS), CHAP has the regulatory authority to survey agencies providing home health, hospice and home medical equipment services, to determine if they meet the Medicare Conditions of Participation and CMS Quality Standards. CHAP’s purpose is to define and advance the highest standards of community-based care.

For more information about AAA Nursing Services, please visit their website at www.aaanursinginc.com. For additional information on AAA Nursing Services, please contact David Felender, Administrator, at david@aaanursinginc.com.