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Services: In Home Care Respite Care Hospice Care Elder Care Elder Companionship Home Hospice Family Support Assisted Living
Our in-depth background check is performed to ensure our staff’s credentials and their reputation in caring for your family member or loved one. We assure you that our caregivers will treat your senior loved one and family with the loving care they deserve.
We handle all the Long Term Care Insurance paperwork!
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Home Care Today! There are more options than nursing homes...
used to think that nursing homes, assisted living communities and
other care centers were the only solutions for aging loved ones
when they began to change physically and cognitively. Now seniors
and their families have choices to stay right at home.
24 HOUR CARE & PART-TIME / FULL TIME CARE
HOUR HOME CARE
“A caregiver is in the home providing care between 24 hours a day, and is available to assist morning, noon, and night. All caregivers are employees of Accessible Health Care and we schedule and document each agreed upon service. 24 hour care is usually needed when the adult cannot be left unattended during the day or night, yet the client is able to sleep through most of the night. Caregivers assist with daily activities such as cooking, cleaning, laundry, and simple household chores. We also help with personal care such as bathing, dressing, personal hygiene, and incontinence care. Having a caregiver also ensures that medications are taken on time, visits to doctor are made and notes are taken so that the family and client can refer to them later. We are happy to provide transportation and assist with trips into the community as much as you would like to get out and about. It is an important part of maintaining mental health to have as normal a life as possible for both the one being cared for and the family.
Symptoms of depression can be minimized with a caregiver who can provide friendship and care daily. Historically, assisted living facilities and nursing homes have been viewed as the only choice for elderly people who need around-the-clock personal, non-medical home care. Unfortunately, neither institution can guarantee the type of consistent, compassionate, one-on-one attention your elderly loved one deserves in the familiarity and comfort of their own home. “
- Can speak, read and understand English very well. They are carefully screened by doing a background check with the Department of Justice, FBI and DMV records.
- They are well trained companions, certified Home Health Aides (CHHA), Nurses Aides, Companions and Homemakers who are CPR certified. They are bonded, insured & covered by workman's compensation.
- We pride ourselves in taking extra care to match our clients
with their caregivers. We believe it is extremely important
to provide compatibility.
Caring for your loved one we regularly do:
- Parkinson's Disease Care
- Multiple Sclerosis
- Disabled Adults / Children
- Alzheimer's Disease
- Live-in Care / Hourly Care / Overnight Care-
- Meal preparation, laundry and light housekeeping
- Errands and shopping
- Medication Management
- Personal care and grooming
- Monitoring vital signs
- Transportation to doctors appointments
- Incontinence care
- Exercise and mobility assistance
- Respite and Hospice relief
- Companionship and friendly conversation
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Family... take a break from the daily routine and stress!
Respite care is the provision of short-term, temporary relief to those who are caring for family members who might otherwise require permanent placement in a facility outside the home.
Caregiving is a demanding, difficult job and no one is equipped to do it alone. Getting help is essential for your health, and is critical for your loved one.
provide planned short-term and time-limited breaks for families
and other unpaid care givers of children with a developmental
delay and adults with an intellectual disability in order to support
and maintain the primary care giving relationship. Respite also
provides a positive experience for the person receiving care.
The term "short break" is used in some countries to
describe respite care.
Seeking support and maintaining one's own health are key to managing
the caregiving years.
Respite care has two main themes:
1) Sharing the responsibility for caregiving.
2) With getting support for yourself you can find the right balance of persistence, patience, and preparation.
We specialize in various models for providing respite care including:
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We care for adult and pediatric patients with a wide range of life-limiting illnesses, including cancer, stroke, heart disease, lung disease, liver disease, kidney disease, multiple sclerosis, ALS, Alzheimer's and More!
Hospice is more a concept of care than a specific place. It is an option for people whose life expectancy is six months or less, and involves palliative care (pain and symptom relief) rather than ongoing curative measures, enabling you to live your end days to the fullest, with purpose, dignity, grace and support.
Our Hospice care gives medical, psychological and spiritual support. The goal of the care is to help people who are dying have peace, comfort and dignity.
Our caregivers try to control pain and other symptoms so a person can remain as alert and comfortable as possible.
Our Hospice program also provide services to support a patient's family.
When medical treatments can no longer cure a disease, our team of hospice caregivers still can do a great deal to control pain, reduce anxiety and offer needed spiritual and emotional support to patients and their families.
Us Today (949) 859-4772
Where do we start when looking for resources for elder care for a loved one?
Resources that can help the elderly stay in their own home are the first place to start. A variety of independent living services are now available to help the elderly care for themselves in their own home despite their changing physical needs. This may help, delay or totally avoid moving into an assisted living or nursing home.
Elder care, sometimes referred to as long-term elderly care, includes a wide range of services that are provided over an extended period of time to people who need help to perform normal activities of daily living because of cognitive impairment or loss of muscular strength or control. Elder care can include rehabilitative therapies, skilled nursing care, palliative care, and social services, as well as supervision and a wide range of supportive personal care provided by family caregivers and/or home health care agencies. Elder care may also include training to help older people adjust to or overcome many of the limitations that often come with aging. If appropriate, elder care can at best be provided in the home first.
Sometimes, elder people refuse to shift to other places, even if the situation demands. For example, due to higher education or better career options relocating become inevitable. Sometimes, senior adults suffer from a sense of insecurity and lack the self-confidence. They prefer to stay at their own known place. Under this kind of situation, home care services for the elderly are one of the effective solutions.
Elder care is not limited to providing medical care. The aim of elderly home care ensures that senior adults lead an active lifestyle. Elderly home care ensures that adults become self-sufficient as much as possible. The caregivers or the companions help the adults in taking part in various activities according to their interest. With an active body, the mind equally becomes active, thereby adults regaining their self-confidence.
It is a pity that many senior citizens are moved to nursing-homes or hospitals, who might just require helping hand in running daily tasks of life. The solution to this type of problems lies in the hand of elderly home care services. Senior citizens, who need non-medical support, are also benefitted from this service. Senior home care services can provide a substitute to long-term care.
Since, in most of the cases working persons are unable to give adequate time, the variant services of the senior home care service works as a good alternative. These services include light housekeeping, meal preparation, errands and shopping, respite care, meditation assistance, hygiene assistance to name a few.
The longer period senior citizen spends time at their own home, they will stay healthy both physically and mentally. Take advantage of elderly home care to ensure a better life of your elderly loved one.
For more information or if you have any questions please call us.
Call Us Today at (949) 859-4772
"Home care", "home health care", "in-home care" are phrases that are used interchangeably in the United States to mean any type of care given to a person in their own home. Both phrases have been used in the past interchangeably regardless of whether the person requires skilled care or not. More recently, there is a growing movement to distinguish between "home health care" meaning skilled nursing care and "home care" meaning non-medical care. In the United Kingdom, "homecare" and "domiciliary care" are the preferred expressions.
Home care aims to make it possible for people to remain at home rather than use residential, long-term, or institutional-based nursing care. Home care providers render services in the client's own home. These services may include some combination of professional health care services and life assistance services.
Professional home health services could include medical or psychological assessment, wound care, medication teaching, pain management, disease education and management, physical therapy, speech therapy, or occupational therapy.
Life assistance services include help with daily tasks such as meal preparation, medication reminders, laundry, light housekeeping, errands, shopping, transportation, and companionship.
While there are differences in terms used in describing aspects of home care or home health care in the United States and other areas of the world, for the most part the descriptions are very similar.
Estimates for the U.S. indicate that most home care is informal with families and friends providing a substantial amount of care. For formal care, the health care professionals most often involved are nurses followed by physical therapists and home care aides. Other health care providers include respiratory and occupational therapists, medical social workers and mental health workers. Home health care is generally paid for by Medicaid, long term insurance, or paid with the patient's own resources.
Aide worker qualifications
It is not a requirement that you have a GED or high school diploma, you will need to check with your local department of health for state requirements. Often aide workers have experience in institutional care facilities prior to a home care agency. Workers can take an examination to become a state tested Certified Nursing Assistant (CNA). Other requirements in the U.S.A. often include a background check, drug testing, and general references.
Licensure and providers by state
California California is NOT a licensure state for non medical or custodial care services and therefore there are no barriers to entry, no consumer protection laws, no minimum standards yet and no official state oversight. In California the consumers and their families must adopt a "buyer beware" approach, do their homework and hire caregivers that are bonded and insured. This is why it is important to use a full service agency that has supervision and oversight of staff. Full service agencies also do preemployment background check (criminal), department of motor vehicle checks and reference checks. Staff become the agency's employee not an independent contractor or "under the table" person. Full service agencies also train, monitor and supervise the staff that provide care to clients in their home.
Payments and Fees
Recent AB241 Home Care
On January 1, 2014, passage by the California legislature of AB -241 Caregivers, Companions, and domestic workers, employed by all Agencies, or by individual clients directly, is changing the method of payment by requiring that the live in caregivers are compensated on an hourly basis rather than daily rate. Furthermore the legislation requires that the caregiver be paid overtime for all hours worked over 9 in a day or 45 in a work week. This is a mandatory law and all legally operating agencies have to comply. If you decide to employ a caregiver directly you will be classified as an employer of record and would be required to pay overtime and pay all the matching FICA, unemployment insurance and withholdings, keep appropriate records, file tax returns and submit timely payments to the State of California and IRS. Agencies (not registries) are already complying with state and federal law mandates.
California AB 241
- Effective January 1, 2014, a new law called The Domestic Worker Bill of Rights was enacted which defines domestic work as services related to the care of persons in private households or maintenance of private households or their premises.
- Domestic work occupations include caregivers of elderly persons, people with disabilities, sick or convalescing, and other household occupations, either full time or part time work.
- "Domestic work employer" includes an individual who employs or exercises control over the wages, hours, or working conditions of a domestic work employee.
- This definition confirms the private person organizing the care rather than the individual needing the care as the employer.
- Before AB241 families in need of 24 hour care would typically hire a live in caregiver. Providing room and board has traditionally been part of the caregiver’s compensation in addition to an agreed upon monthly monetary payment.
- After Jan 1, 2014, the room and board portion cannot be considered part of the compensation to the caregiver for their services. Compensation/wages now are entirely an hourly calculation of at least minimum wage (currently $ 9 per hour) for every hour worked, (asleep or awake in the household).
- Now 24 hour care is 24 paid hours at your negotiated hourly rate.
- A shift over 9 hours in a day or 45 hours in a week is earns wages at time and ½.
- This makes how those hours are structured vital to how much each day of care costs. The least possible cost is 4 caregivers in 8 hour shifts. One alternate caregiver would be needed to cover any sick days of the other 4 caregivers so that everyone stays under 45 hours a week.
- AB241 also requires that the private employer withhold and pay all regular employee / employer taxes. Such as Federal and State withholding, California Disability Insurance, California Unemployment Insurance along with a few other minor taxes.
- Worker’s Compensation Insurance is a separate insurance from regular payroll taxes and is required also. (The CA State Compensation Insurance Fund can be contacted at 888-782-8338.)
- AB241 includes a provision for employees to apply for and receive Unemployment Insurance payments or Disability Insurance payments, regardless of whether or not the employer has purchased the insurance.
- This allows the state to both protect the worker and to verify with the individual-employer that all tax payments and-or penalties have been applied.
- Personal assets of the employer can be attached by the State or Federal government to pay the domestic worker all unpaid wages and related taxes.
2004 Study by NIHS
In February 2004, the National Center for Health Statistics (NCHS) conducted the "National Home and Hospice Study," which was updated in 2005.
The data was collected on about approximately 1.3+ million (1,355,300) persons receiving home care in the USA. Of that total, almost 30% (29.5% or 400,100 persons) were under 65 years of age, while the majority, almost 70%, were over 65 years old (70.5% or 955,200 persons).
The 2005 chart data of estimates based on interviews with non-institutionalized citizens, however, shows a relatively stable number of about 6 to 7 percent of adults age 65 who needed help for personal care (ADLs) - this has remained about the same between 1997 and 2004. (Data has a 95% reliability.) Those aged 85 or older were at least 6 times more likely (20.6%) to need ADL assistance than those of age 65. Between age 65 and 85 years, more women than men needed help.
To review the 2005 Early Release data used, visit the NCHS-NHIS website to see the PDF files. [NOTE: * The 2005 data reflects data, still between 6 to 7%, is only based on interviews conducted between January to June 2005, so it remains to be seen whether the figure remained constant or changed through the end of 2005.] Again, the 1998-2005 data is specific for over 65 or older and does not include any data for adults under 65 years old.
In the 2004 data, just over 30% (30.2% or 385,500) of the total 1.3+million persons lived alone, but the study did not break this down by age groups. A large portion, 1,094,900 or 80.8% had a primary caregiver, and almost 76% (75.9% or 831,100 lived with the primary caregiver, typically the spouse, child or child-in-law, other relative or parent, in that order. (Paid help and the category of neighbor/friend/ or unknown caregiver would be, for the majority, were living with non-family (4.3%) or unknown living arrangement .) Most patients still need external help, even if the primary caregiver is a spouse.
A total of 600,900 persons received personal care.
Payment described in the 2004 study
Page 4 of the study describes the population break-down by type of payment used. Of the 1.3+ million:
710,000 paid by Medicare - Medicare often is the primary billing source, if this is the primary carrier between two types of insurance (like between Medicare and Medicaid). Also, if a patient has Medicare and that patient has a "skilled need" requiring nursing visits, the patient's case is typically billed under Medicare.
277,000 paid by Medicaid - This number seems low for Community Based Services (CBS) or Home Care (HC), especially as a nationwide statistic.
235,000 paid by private insurance, or self/family - Private insurance includes VA (Veterans Administration), some Railroad or Steelworkers health plans or other private insurance. "Self/family" indicates "private pay" status, when the patient or family pays 100% of all home care charges. Home care fees can be quite high; few patients & families can absorb these costs for a long period of time.
133,200 all other payments - including patients unable to pay, or who had no charge for care, or those whose payment "source not yet determined or approved." Sometimes after "opening a case" (the formal paperwork process of admitting a patient to home care services, there can be a short period of time when the office has not yet received approval by one of two or more insurances held by the patient. This is not unusual. There can also be cases where the office must make phone calls to be sure a particular diagnosis is "covered" by the patient's primary insurance. This is not unusual. These delays explain, in part, a couple circumstances where payment source would be listed as "unknown."
Community-Based Long Term Care (CBLTC) is the newer name for Home Health Care Services paid by States' Medicaid programs. Most of these programs have a category called 'Medicaid Waiver' to define level of care being delivered.
The Study "Medicaid Home and Community-Based Long Term Care – Trends in the U.S. and Maryland" funded by the National Institute of Disability and Rehabilitation Research, Department of Education, Information Brokering for Long Term Care, The Robert Wood Johnson Foundation, focused on expenditures. In this study, the Medicaid Waiver Expenditures by Recipient Group in 2001 based on total expenditure of $14,218,236,802 was broken down in this manner of actual spending (presumably this is based on nationwide figures):
But, the same report included figures on "Participants by Recipient Type" in 2001 based on a total number of 832,915. Participant types were broken down thus (presumably this is based on nationwide figures):
Respite care is the provision of short-term, temporary relief to those who are caring for family members who might otherwise require permanent placement in a facility outside the home.
Respite programs provide planned short-term and time-limited breaks for families and other unpaid care givers of children with a developmental delay and adults with an intellectual disability in order to support and maintain the primary care giving relationship. Respite also provides a positive experience for the person receiving care. The term "short break" is used in some countries to describe respite care.
In the United States today there are approximately 50 million people who are caring at home for family members including elderly parents, and spouses and children with disabilities and/or chronic illnesses. Without this home-care, most of these cared for loved ones would require permanent placement in institutions or health care facilities.
Even though many families take great joy in providing care to their loved ones so that they can remain at home, the physical, emotional and financial consequences for the family caregiver can be overwhelming without some support, such as respite. Respite provides the much needed temporary break from the often exhausting challenges faced by the family caregiver.
Respite is the service most often requested by family caregivers, yet it is in critically short supply, inaccessible, or unaffordable regardless of the age or disability of the individual needing assistance. While the focus has been on making sure families have the option of providing care at home, little attention has been paid to the needs of the family caregivers who make this possible.
Without respite, not only can families suffer economically and emotionally, caregivers themselves may face serious health and social risks as a result of stress associated with continuous caregiving. Three fifths of family caregivers age 19-64 surveyed recently by the Commonwealth Fund reported fair or poor health, one or more chronic conditions, or a disability, compared with only one-third of non caregivers.
Respite has been shown to help sustain family caregiver health and wellbeing, avoid or delay out-of-home placements, and reduce the likelihood of abuse and neglect. An outcome based evaluation pilot study show that respite may also reduce the likelihood of divorce and help sustain marriages.
Models for Respite
There are various models for providing respite care including:
In-home care is popular for obvious reasons. The temporary caregiver comes to the regular caregiver’s home, and gets to know the care receiver in his or her normal environment. The temporary caregiver learns the family routine, where medicines are stored, and the care receiver is not inconvenienced by transportation and strange environments. In this model, friends, relatives and paid professionals may be used. Depending on the state, Medicaid or Medicare may be used to help cover costs. Another in-home model will utilize friends and neighbors as helping hands where the primary caregiver never leaves the premises but may simply be getting a break so that they can cook dinner or pay the bills.
Another model uses a specialized, local facility where the care receiver may stay for a few days or a few weeks. The advantage of this model is that the specialized facility will probably have better access to emergency facilities and professional assistance if needed.
There may be the need for respite care on an emergency basis. When using "planned" emergency care, the caregiver has already identified a provider or facility to call in case there is an emergency. Many homecare agencies, adult day care, health centers, and residential care facilities provide emergency respite care.
Sitter-companion services are sometimes provided by local civic groups, the faith community and other community organizations. A regular sitter-companion can provide friendly respite care for a few hours, once or twice a week. Care must be taken to assure that the sitter-companion is trained in what to do if an emergency occurs while the regular care-giver is out of the home.
Therapeutic adult day care
Therapeutic adult day care may provide respite care during business hours five days a week.
The Lifespan Respite Act
Recognizing this significant contribution and the needs faced by America’s caregivers, the United States Congress passed The Lifespan Respite Care Act of 2006 (HR 3248) which was signed into law in December 2006. The bill was introduced and championed in the US House of Representatives by Rep. Mike Ferguson and James Langevin (D-RI). A companion bill in the Senate was cosponsored by Senator Hillary Clinton (D-NY) and Senator John Warner.
Much of the success for the passage of this legislation is due to the work of The Lifespan Respite Task Force which includes a diverse group of national and state organizations, state respite and crisis care coalitions; health and community social services; disability, mental health, education, faith, family caregiving and support groups; groups from the child advocacy and the aging community; and abuse and neglect prevention groups.
If and when the new law is funded, (check progress at the ARCH website) it will provide funds for states to develop lifespan respite programs to help families access quality, affordable respite care. Lifespan respite programs are defined in the Act “as coordinated systems of accessible, community-based respite care services for family caregivers of children and adults with special needs.” Specifically, the law authorizes funds for:
When the bill passed the House, Rep. Ferguson, whose own father was a caregiver for his ill mother for six years said , “Today's action by the House of Representatives represents not only an important victory for family caregivers nationwide, but it also sends America's caregivers a clear message: Your selfless sacrifice is appreciated, and help is on the way.”
The Lifespan Respite Care Act of 2006 is based on model state lifespan respite programs that have successfully addressed all of these barriers. Three states have enacted legislation to implement lifespan respite programs (Oregon, Nebraska, Wisconsin), which establish state and local infrastructures for developing, providing, coordinating and improving access to respite for all caregivers, regardless of age, disability or family situation. Oklahoma has also implemented a successful lifespan respite program.
Respite in the US
An estimated 50 million family caregivers nationwide provide at least $306 billion in uncompensated services — an amount comparable to Medicare spending in 2004 and more than twice what is spent nationwide on nursing homes and paid home care combined. Family caregivers may suffer from physical, emotional, and financial problems that impede their ability to give care now and support their own care needs in the future. Without attention to their needs, their ability to continue providing care may well be jeopardized.
Respite care is one of the services that Alzheimer’s caregivers say they need most. One study found that if respite care delays institutionalization of a person with Alzheimer’s disease by as little as a month, $1.12 billion is saved annually. A similar study in 1995 found that as respite use increased, the probability of nursing home placement decreased significantly
U.S. businesses also incur high costs in terms of decreased productivity by stressed working caregivers. A study by MetLife estimates the loss to U.S. employers to be between $17.1 and $33.6 billion per year. This includes replacement costs for employees who quit because of overwhelming caregiving responsibilities, absenteeism, and workday interruptions.
Caregiver wellness reduces hospitalizations, doctor visits, work absences
Significant percentages of family caregivers report physical or mental health problems due to caregiving. A recent survey of caregivers of children, adults and the disabled conducted by the National Family Caregivers Association, found that while 70% of the respondents reported finding an inner strength they didn’t know they had, 27% reported having more headaches, 24% reported stomach disorders, 41% more back pain, 51% more sleeplessness and 61% reported more depression.
Three fifths of family caregivers age 19-64 surveyed recently by the Commonwealth Fund reported fair or poor health, one or more chronic conditions, or a disability, compared with only one-third of non caregivers. Caregivers reported chronic conditions at nearly twice the rate of non caregivers (45% to 24%).
A 1999 study in the Journal of the American Medical Association found that participants who were providing care for an elderly individual with a disability and experiencing caregiver strain had mortality risks that were 63% higher than non caregiving controls.
In an Iowa survey of parents of children with disabilities, a significant relationship was demonstrated between the severity of a child’s disability and their parents missing more work hours than other employees. They also found that the lack of available respite care appeared to interfere with parents accepting job opportunities.
Respite for younger family members with disabilities
Respite has been shown to improve family functioning, improve satisfaction with life, enhance the capacity to cope with stress, and improve attitudes toward the family member with a disability.
In a 1989 US national survey of families of a child with a disability, 74% reported that respite had made a significant difference in their ability to provide care at home; 35% of the respite users indicated that without respite services they would have considered out-of-home-placement for their family member.
There was a statistically significant reduction in somatic complaints by in a study of primary caregivers of children with chronic illnesses, and a decrease in the number of hospitalization days required by children, as a direct result of respite care.
Data from an ongoing research project of the Oklahoma State University on the effects of respite care found that the number of hospitalizations, as well as the number of medical care claims decreased as the number of respite care days increased.
A Massachusetts social services program designed to provide cost-effective family-centered respite care for children with complex medical needs found that for families participating for more than one year, the number of hospitalizations decreased by 75%, physician visits decreased by 64%, and antibiotics use decreased by 71%.
An evaluation of the Iowa Respite Child Care Project for families parenting a child with developmental disabilities found that when respite care is used by the families, there is a statistically significant decrease in foster care placement.
A 1999 study of Vermont’s then 10-year-old respite care program for families with children or adolescents with serious emotional disturbance found that participating families experience fewer out-of home placements than nonusers and were more optimistic about their future capabilities to take care of their children.
Results when caregivers of the elderly use respite
Respite for the elderly with chronic disabilities in a study group resulted in fewer hospital admissions for acute medical care than for two other control groups who received no respite care
Sixty-four percent of caregivers of the elderly receiving 4 hours of respite per week, after one year, reported improved physical health. Seventy-eight percent improved their emotional health, and 50% cited improvement in the care recipient as well. Forty percent said they were less likely to institutionalize the care recipient because of respite.
Caregivers of relatives with dementia who use adult day care experience lower levels of caregiving related stress and better psychological well-being than a control group not using this service. These differences were found in both short-term (3 months) and long-term (12 months) users.
Respite provided across the lifespan yields positive outcomes
In a 2004 survey conducted by the Oklahoma Respite Resource Network, 88% of caregivers agreed that respite allowed their loved one to remain at home, 98% of caregivers stated that respite made them a better caregiver, 98% of caregivers said respite increased their ability to provide a less stressful environment, and 79.5% of caregivers said respite contributed to the stability of their marriage.
When newly formed, the Nebraska statewide lifespan respite program conducted a statewide survey of a broad array of caregivers who had been receiving respite services, and found that one in four families with children under 21 reported that they were less likely to place their child in out-of-home care once respite services were available. In addition, 79% of the respondents reported decreased stress and 58% reported decreased isolation.
Data from an outcome based evaluation pilot study show that respite may also reduce the likelihood of divorce and help sustain marriages
Hospice is a type of care and a philosophy of care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice has been evolving since the 11th century. Then, and for centuries thereafter, hospices were places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims. The modern concept of hospice includes palliative care for the incurably ill given in such institutions as hospitals or nursing homes, but also care provided to those who would rather die in their own homes. It began to emerge in the 17th century, but many of the foundational principles by which modern hospice services operate were pioneered in the 1950s by Dame Cicely Saunders. Although the movement has met with some resistance, hospice has rapidly expanded through the United Kingdom, the United States and elsewhere.
The early development of hospice
Linguistically, the word "hospice" is derived from the Latin hospes, a word which served double-duty in referring both to guests and hosts. The first hospices are believed to have originated in the 11th century, around 1065, when for the first time the incurably ill were permitted into places dedicated to treatment by Crusaders. In the early 14th century, the order of the Knights Hospitaller of St. John of Jerusalem opened the first hospice in Rhodes, meant to provide refuge for travelers and care for the ill and dying. Hospices flourished in the Middle Ages, but languished as religious orders were dispersed. They were revived in the 17th century in France by the Daughters of Charity of Saint Vincent de Paul. France continued to see development in the hospice field; the hospice of L'Association des Dames du Calvaire, founded by Jeanne Garnier, opened in 1843. Six other hospices followed before 1900.
Meanwhile, hospices were established as well in other areas. In the United Kingdom, attention was drawn to the needs of the terminally ill in the middle of the 19th century, with Lancet and the British Medical Journal publishing articles pointing to the need of the impoverished terminally ill for good care and sanitary conditions. Steps were taken to remedy inadequate facilities with the opening of the Friedenheim in London, which by 1892 offered 35 beds to patients dying of tuberculosis. Four more hospices were established in London by 1905. Australia, too, was seeing active hospice development, with notable hospices including the Home for Incurables in Adelaide (1879), the Home of Peace (1902) and the Anglican House of Peace for the Dying in Sydney (1907). In 1899, New York City saw the opening of St. Rose's Hospice by the Servants for Relief of Incurable Cancer, who soon expanded with six locations in other cities.
Among the more influential early developers of Hospice were the Irish Religious Sisters of Charity, who opened Our Lady's Hospice in Harold's Cross, Dublin, Ireland in 1879. It proved to be very busy, with as many as 20,000 people—primarily suffering tuberculosis and cancer—coming to the hospice to die between 1845 and 1945. The Sisters of Charity expanded internationally, opening the Sacred Heart Hospice for the Dying in Sydney in 1890, with hospices in Melbourne and New South Wales following in the 1930s. In 1905, they opened St Joseph's Hospice in London. It was there in the 1950s that Cicely Saunders developed many of the foundational principles of modern hospice care.
The rise of the modern hospice movement
Saunders was an English registered nurse whose chronic health problems had forced her to pursue a career in medical social work. The relationship she developed with a dying Polish refugee helped solidify her ideas that terminally ill patients needed compassionate care to help address their fears and concerns as well as palliative comfort for physical symptoms. After the refugee's death, Saunders began volunteering at St Luke's Home for the Dying Poor, where a physician told her that she could best influence the treatment of the terminally ill as a physician. Saunders entered medical school while continuing her volunteer work at St. Joseph's. When she achieved her degree in 1957, she took a position there.
Saunders emphasized focusing on the patient rather than the disease and introduced the notion of 'total pain', which included psychological and spiritual as well as the physical aspects. She experimented with a wide range of opioids for controlling physical pain but included also the needs of the patient's family. She disseminated her philosophy internationally in a series of tours of the United States that began in 1963. In 1967, Saunders opened St. Christopher's Hospice. Florence Wald, the dean of Yale School of Nursing who had heard Saunders speak in America, spent a month working with Saunders there in 1969 before bringing the principles of modern hospice care back to the United States, establishing Hospice, Inc. in 1971.
At about the same time that Saunders was disseminating her theories and developing her hospice, in 1965, Swiss psychiatrist Elisabeth Kübler-Ross also began to consider the social responses to terminal illness, which she found inadequate at the Chicago hospital where her American physician husband was employed. Her 1969 best-seller, On Death and Dying, was influential on how the medical profession responded to the terminally ill, and along with Saunders and other thanatology pioneers helped to focus attention on the types of care available to them.
Hospice care around the world
Hospice has faced resistance springing from various factors, including professional or cultural taboos against open communication about death among physicians or the wider population, discomfort with unfamiliar medical techniques, and professional callousness towards the terminally ill. Nevertheless, the movement has, with national differences in focus and application, spread throughout the world.
In 1984, Dr. Josefina Magno, who had been instrumental in forming the American Academy of Hospice and Palliative Medicine and sat as first executive director of the US National Hospice Organization, founded the International Hospice Institute, which in 1996 became the International Hospice Institute and College and later the International Association for Hospice and Palliative Care (IAHPC). The IAHPC, with a board of directors as of 2008 from such diverse countries as Scotland, Argentina, Hong Kong and Uganda, works from the philosophy that each country should develop a palliative care model based on its own resources and conditions, evaluating hospice experiences in other countries but adapting to their own needs. Dr. Derek Doyle, who was a founding member of IAHPC, told the British Medical Journal in 2003 that through her work the Philippine-born Magno had seen "more than 8000 hospice and palliative services established in more than 100 countries."Standards for Palliative and Hospice Care have been developed in a number of countries around the world, including Australia, Canada, Hungary, Italy, Japan, Moldova, Norway, Poland, Romania, Spain, Switzerland, the United Kingdom and the United States.
In 2006, the United States based National Hospice and Palliative Care Organization (NHPCO) and the United Kingdom's Help the Hospices jointly commissioned an independent, international study of worldwide palliative care practices. Their survey found that 15% of the world's countries offered widespread palliative care services with integration into major health care institutions, while an additional 35% offered some form of palliative care services, though these might be localized or very limited. As of 2009, there were an estimated 10,000 programs internationally intended to provide palliative care, although the term hospice is not always employed to describe such services.
Hospice care in Africa
1980 saw the opening of a hospice in Harare, Zimbabwe, the first in Sub-Saharan Africa. In spite of skepticism in the medical community, the hospice movement spread, and in 1987 the Hospice Palliative Care Association of South Africa formed In 1990, Nairobi Hospice opened in Nairobi, Kenya. As of 2006, Kenya, South Africa and Uganda were among the 35 countries of the world offering widespread, well-integrated palliative care. Programs there are based on the United Kingdom model, but focus less on in-patient care, emphasizing home-based assistance.
Since the foundation of hospice in Kenya in the early 1990s, palliative care has spread through the country. Representatives of Nairobi Hospice sit on the committee to develop a Health Sector Strategic Plan for the Ministry of Health and are working with the Ministry of Health to help develop specific palliative care guidelines for cervical cancer. The Government of Kenya has supported hospice by donating land to Nairobi Hospice and providing funding to several of its nurses.
In South Africa, hospice services are widespread, focusing on diverse communities (including orphans and homeless) and offered in diverse settings (including in-patient, day care and home care). Over half of hospice patients in South Africa in the 2003-2004 year were diagnosed with AIDS, with the majority of the remaining having been diagnosed with cancer. Palliative care in South Africa is supported by the Hospice Palliative Care Association of South Africa and by national programmes partly funded by the President's Emergency Plan for AIDS Relief.
Hospice Africa Uganda (HAU) began offering services in 1993 in a two-bedroom house loaned for the purpose by Nsambya Hospital. HAU has since expanded to a base of operations at Makindye, Kampala, with hospice services also offered at roadside clinics by Mobile Hospice Mbarara since January 1998. That same year saw the opening of Little Hospice Hoima in June. Hospice care in Uganda is supported by community volunteers and professionals, as Makerere University offers a distance diploma in palliative care. The government of Uganda has a strategic plan for palliative care and permits nurses and clinical officers from HAU to prescribe morphine.
care in North America
|County of Orange|
|— County —|
|Incorporated||March 11, 1889|
|County seat||Santa Ana|
|- Total||948 sq mi (2,455.3 km2)|
|- Land||789 sq mi (2,043.5 km2)|
|- Water||159 sq mi (411.8 km2)|
|Population (2008 Est.)||3,010,759|
|- Density||3,815/sq mi (1,473/km2)|
|Time zone||Pacific Standard Time (UTC-8)|
|- Summer (DST)||Pacific Daylight Time (UTC-7)|
Orange County is a county in California, within the United States. Its county seat is Santa Ana. As of the 2000 census, its population was 2,846,293, while a July 2008 estimate placed the population at 3,010,759, making it the second most populous county in California, behind Los Angeles County and ahead of San Diego County.
The county is famous for its tourism, as the home of such attractions as Disneyland and Knott's Berry Farm, as well as several beaches along its more than 40 miles (64 km) of coastline. It is also known for its affluence and political conservatism. In fact, a 2005 academic study listed three Orange County cities as being among America's 25 "most conservative," making it the only county in the country containing more than one such city. It also became well-known for being the largest US county ever to have gone bankrupt, when in 1994 citizens rejected tax increases to pay back debts incurred by the county treasurer's misinvestments.
Whereas most population centers in the United States tend to be identified by a major city, there is no defined urban center in Orange County. It is mostly suburban, except for some traditionally urban areas such as those of Anaheim, Santa Ana, Orange, Huntington Beach, and Fullerton. There are also several edge city-style developments such as South Coast Metro and Newport Center.
While Santa Ana serves as the governmental center of the county, Anaheim is its main tourist destination, and Irvine its major business and financial hub. Four Orange County cities have populations exceeding 200,000: Santa Ana, Anaheim, Irvine, and Huntington Beach.
Thirty-four incorporated cities are located in Orange County; the newest is Aliso Viejo, which was incorporated in 2001. Anaheim was the first city incorporated in Orange County, in 1870 when the region was still part of neighboring Los Angeles County.
Members of the Tongva, Juaneño, and Luiseño Native American groups long inhabited the area. After the 1769 expedition of Gaspar de Portolà, a Spanish expedition led by Junipero Serra named the area Valle de Santa Ana (Valley of Saint Anne). On November 1, 1776, Mission San Juan Capistrano became the area's first permanent European settlement. Among those who came with Portolá were José Manuel Nieto and José Antonio Yorba.Both these men were given land grants - Rancho Los Nietos and Rancho Santiago de Santa Ana, respectively. The Nieto heirs were granted land in 1834. The Nieto ranches were known as Rancho Los Alamitos, Rancho Las Bolsas, and Rancho Los Coyotes. Yorba heirs Bernardo Yorba and Teodosio Yorba were also granted Rancho Cañón de Santa Ana (Santa Ana Canyon Ranch) and Rancho Lomas de Santiago, respectively. Other ranchos in Orange County were granted by the Mexican government during the Mexican period in Alta California.
A severe drought in the 1860s devastated the prevailing industry, cattle ranching, and much land came into the possession of Richard O'Neill, Sr., James Irvine and other land barons. In 1887, silver was discovered in the Santa Ana Mountains, attracting settlers via the Santa Fe and Southern Pacific Railroads.
This growth led the California legislature to divide Los Angeles County and create Orange County as a separate political entity on March 11, 1889. The county is generally said to have been named for the citrus fruit (its most famous product). However, in the new county there was already a town by the name of Orange, named for Orange County, Virginia, which itself took its name from William of Orange. The fact the county took the same name as one of its towns may have been coincidence.
Other citrus crops, avocados, and oil extraction were also important to the early economy. Orange County benefited from the July 4, 1904 completion of the Pacific Electric Railway, a trolley connecting Los Angeles with Santa Ana and Newport Beach . The link made Orange County an accessible weekend retreat for celebrities of early Hollywood. It was deemed so significant that the city of Pacific City changed its name to Huntington Beach in honor of Henry Huntington, president of the Pacific Electric and nephew of Collis Huntington. Transportation further improved with the completion of the State Route and U.S. Route 101 (now mostly Interstate 5) in the 1920s.
Agriculture, such as the boysenberry which was made famous by Buena Park native Walter Knott, began to decline after World War II but the county's prosperity soared. The completion of Interstate 5 in 1954 helped make Orange County a bedroom community for many who moved to Southern California to work in aerospace and manufacturing. Orange County received a further boost in 1955 with the opening of Disneyland.
In the 1980s, the population topped two million for the first time; Orange County had become the second-most populous county in California.
An investment fund melt-down in 1994 led to the criminal prosecution of County of Orange treasurer Robert Citron. The county lost at least $1.5 billion through high-risk investments in derivatives. On December 6, 1994, the County of Orange declared Chapter 9 bankruptcy, from which it emerged in June 1995. The Orange County bankruptcy was the largest municipal bankruptcy in U.S. history.
In recent years land-use conflicts have arisen between established areas in the north and less developed areas in the south. These conflicts have regarded things such as construction of new toll roads and the re-purposing of a decommissioned air base. For example, the El Toro Marine Corps Air Station site was designated by a voter measure in 1994 to be developed into an international airport to alleviate the heavily used John Wayne Airport. But subsequent voter initiatives and court actions have caused the airport plan to be permanently shelved. Instead it will become the Orange County Great Park.
According to the U.S. Census Bureau, the county has a total area of 2,455 km2 (948 sq mi), making it the smallest county in Southern California. Surface water accounts for 411 km2 (159 sq mi) of the area, 16.73% of the total; 2,044 km2 (789 sq mi) of it is land. The average annual temperature is about 68 °F (20 °C). Despite its small size as a county, Orange County's total area in square miles is actually just smaller than the State of Rhode Island's land area.
Orange County is bordered on the southwest by the Pacific Ocean, on the north by Los Angeles County, on the northeast by San Bernardino County and Riverside County, and on the southeast by San Diego County.
The northwestern part of the county lies on the coastal plain of the Los Angeles Basin, while the southeastern end rises into the foothills of the Santa Ana Mountains. Most of Orange County's population reside in one of two shallow coastal valleys that lie in the basin, the Santa Ana Valley and the Saddleback Valley. The Santa Ana Mountains lie within the eastern boundaries of the county and of the Cleveland National Forest. The high point is Santiago Peak (5,689 feet (1,734 m)), about 20 mi (32 km) east of Santa Ana. Santiago Peak and nearby Modjeska Peak, just 200 feet (60 m) shorter, form a ridge known as Saddleback, visible from almost everywhere in the county. The Peralta Hills extend westward from the Santa Ana Mountains through the communities of Anaheim Hills, Orange, and ending in Olive. The Loma Ridge is another prominent feature, running parallel to the Santa Ana Mountains through the central part of the county, separated from the taller mountains to the east by Santiago Canyon.
The Santa Ana River is the county's principal watercourse, flowing through the middle of the county from northeast to southwest. Its major tributary to the south and east is Santiago Creek. Other watercourses within the county include Aliso Creek, San Juan Creek, and Horsethief Creek. In the North, the San Gabriel River also briefly crosses into Orange County and exits into the Pacific on the Los Angeles-Orange County line between the cities of Long Beach and Seal Beach. Laguna Beach is home to the county's only natural lakes, Laguna Lakes, which are formed by water rising up against an underground fault.
Residents sometimes figuratively divide the county into "North Orange County" and "South County" (meaning Northwest and Southeast—following the county's natural diagonal orientation along the local coastline). This is more of a cultural and demographic distinction perpetuated by the popular television shows "The OC" and "Laguna Beach", between the older areas closer to Los Angeles, and the more affluent and recently developed areas to the South and East. A transition between older and newer development may be considered to exist roughly parallel to State Route 55 (aka the Costa Mesa Freeway). This transition is accentuated by large flanking tracts of sparsely developed area occupied until recent years by agriculture and military airfields.
While there is a natural topographical Northeast-to-Southwest transition from inland elevations to the lower coastal band, there is no formal geographical division between North and South County. Perpendicular to that gradient, the Santa Ana River roughly divides the county between northwestern and southeastern sectors (about 40% to 60% respectively, by area), but does not represent any apparent economic, political or cultural differences, nor does it significantly affect distribution of travel, housing, commerce, industry or agriculture from one side to the other.
As of August 2006, Orange County has 34 incorporated cities. The oldest is Anaheim (1870) and the newest is Aliso Viejo (2001).
Some of the communities that exist within city limits are listed below:
These communities are outside of city limits in unincorporated county territory:
Orange County has a history of large planned communities. Nearly 30% of the county was created as master planned communities, the most notable being the City of Irvine, Coto de Caza, Anaheim Hills, Tustin Ranch, Tustin Legacy, Ladera Ranch, Talega, Rancho Santa Margarita, and Mission Viejo. Irvine has become the model master planned city, encompassing many villages which were all planned under a master plan by the Irvine Company in the mid-1960s.
Los Angeles County, California - north, west
San Bernardino County, California - northeast
Riverside County, California - east
San Diego County, California - southeast
|Los Angeles County||San Bernardino County|
|Los Angeles County||Riverside County|
|Orange County, California|
|Pacific Ocean||San Diego County|
National protected areas
Surface transportation in Orange County relies heavily on three major interstate highways: the Santa Ana Freeway (I-5), the San Diego Freeway (I-405 and I-5 south of Irvine), and the San Gabriel River Freeway (I-605), which only briefly enters Orange County territory in the northwest. The other freeways in the county are state highways, and include the perpetually congested Riverside and Artesia Freeway (SR 91) and the Garden Grove Freeway (SR 22) running east-west, and the Orange Freeway (SR 57), the Costa Mesa Freeway (SR/SR 55), the Laguna Freeway (SR 133), the San Joaquin Transportation Corridor (SR 73), the Eastern Transportation Corridor (SR 261, SR 133, SR 241), and the Foothill Transportation Corridor (SR 241) running north-south. Minor stub freeways include the Richard M. Nixon Freeway (SR 90), also known as Imperial Highway, and the southern terminus of Pacific Coast Highway (SR 1). There are no U.S. Highways in Orange County, though two existed in the county until the mid-1960s: 91 and 101. 91 went through what is now the state route of the same number, and 101 was replaced by Interstate 5. SR-1 was once a bypass of US-101 (Route 101A).
Transit in Orange County is offered primarily by the Orange County Transportation Authority. The American Public Transportation Association (APTA) cited OCTA as the best large property transportation system in the United States for 2005. OCTA manages the county's bus network and funds the construction and maintenance of local streets, highways, and freeways; regulates taxicab services; maintains express toll lanes through the median of California State Route 91; and works with Southern California's Metrolink to provide commuter rail service along three lines - the Orange County Line, the 91 Line, and the Inland Empire-Orange County Line.
The bus network comprises 6,542 stops on 77 lines, running along most major streets, and accounts for 210,000 boardings a day. The fleet of 817 buses is gradually being replaced by LNG (liquified natural gas)-powered vehicles, which already represent over 40% of the total.
Starting in 1992, Metrolink has operated three commuter rail lines through Orange County, and has also maintained Rail-to-Rail service with parallel Amtrak service. On a typical weekday, over 40 trains run along the Orange County Line, the 91 Line and the Inland Empire-Orange County Line. Along with Metrolink riders on parallel Amtrak lines, these lines generate approximately 15,000 boardings per weekday. Metrolink also began offering weekend service on the Orange County Line and the Inland Empire-Orange County line in the summer of 2006. As ridership has steadily increased in the region, new stations have opened at Anaheim Canyon, Buena Park, Tustin, and Laguna Niguel/Mission Viejo. Stations at Placentia and Yorba Linda are proposed for future construction.
Orange County's first public Monorail line is undergoing Environmental impact assessment. This line will connect the Disneyland Resort, Convention Center, and Angel Stadium to the proposed ARTIC transportation hub, in the city of Anaheim.
Orange County's only major airport is John Wayne Airport. Although its abbreviation (SNA) refers to Santa Ana, the airport is in fact located in unincorporated territory surrounded by the cities of Newport Beach, Costa Mesa, and Irvine. Unincorporated Orange County (including the John Wayne Airport) has mailing addresses which go through the Santa Ana Post Office. For this reason, SNA was chosen as the IATA Code for the airport. The actual Destination Moniker which appears on most Arrival/Departure Monitors in airports throughout the United States is "Orange County," which is the common nickname used for the OMB Metropolitan Designation: Santa Ana-Anaheim-Irvine, California. Its modern Thomas F. Riley Terminal handles over 9 million passengers annually through 14 different airlines.
According to Census Bureau's 2006 American Community Survey the racial or ethnic makeup of the county was 64.76% White, 16.05% Asian, 0.33% Pacific Islander, 1.72% African American, 0.38% Native American, 14.32% from other races, and 2.44% from two or more races. 32.89% of the population were Hispanic of any race. 30.49% of the population was foreign born.
As of the census of 2000, there were 2,846,289 people, 935,287 households, and 667,794 families residing in the county, making Orange County the second most populous county in California. The population density was 1,392/km² (3,606/sq mi). There were 969,484 housing units at an average density of 474/km² (1,228/sq mi). The racial makeup of the county was 64.81% White, 13.59% Asian, 1.67% African American, 0.70% Native American, 0.31% Pacific Islander, 14.80% from other races, and 4.12% from two or more races. 30.76% are Hispanic or Latino of any race. 8.9% were of German, 6.9% English and 6.0% Irish ancestry according to Census 2000. 58.6% spoke English, 25.3% Spanish, 4.7% Vietnamese, 1.9% Korean, 1.5% Chinese (Cantonese or Mandarin) and 1.2% Tagalog as their first language.
In 1990, still according to the census there were 2,410,556 people residing in the county. The racial makeup of the county was 78.60% White, 10.34% Asian or Pacific Islander, 1.77% African American, 0.50% Native American, and 8.79% from other races. 23.43% were Hispanic or Latino of any race.
There were 935,287 households out of which 37.0% had children under the age of 18 living with them, 55.9% were married couples living together, 10.7% had a female householder with no husband present, and 28.6% were non-families. 21.1% of all households were made up of individuals and 7.2% had someone living alone who was 65 years of age or older. The average household size was 3.00 and the average family size was 3.48.
The population is diverse age-wise, with 27.0% under the age of 18, 9.4% from 18 to 24, 33.2% from 25 to 44, 20.6% from 45 to 64, and 9.9% 65 years of age or older. The median age is 33 years. For every 100 females there were 99.0 males. For every 100 females age 18 and over, there were 96.7 males.
The median income for a household in the county was $61,899, and the median income for a family was $75,700 (these figures had risen to $71,601 and $81,260 respectively as of a 2007 estimate). Males had a median income of $45,059 versus $34,026 for females. The per capita income for the county was $25,826. About 7.0% of families and 10.3% of the population were below the poverty line, including 13.2% of those under age 18 and 6.2% of those age 65 or over.
In 2010 Orange County was voted number 83 on The Daily Caller's list of America's top 100 conservative-friendly counties.
Average household income by community
Unincorporated communities are included if their population is greater than 15,000. These numbers are estimates from the 2005 Census updates for these locales. Numbers are approximate until a new Census occurs.
Orange County is the headquarters of many Fortune 500 companies including Ingram Micro (#69) and First American Corporation (#312) in Santa Ana, Western Digital (#439) in Lake Forest and Pacific Life (#452) in Newport Beach. Irvine is the home of numerous start-up companies and also is the home of Fortune 1000 headquarters for Allergan, Broadcom, Edwards Lifesciences, Epicor, Standard Pacific and Sun Healthcare Group. Other Fortune 1000 companies in Orange County include Beckman Coulter in Fullerton, Quiksilver in Huntington Beach and Apria Healthcare Group in Lake Forest. Irvine is also the home of notable technology companies like PC-manufacturer Gateway Inc., router manufactuer Linksys, and video/computer game creator Blizzard Entertainment. Many regional headquarters for international businesses reside in Orange County like Mazda, Toshiba, Toyota, Samsung, Kia Motors, in the City of Irvine, Mitsubishi in the City of Cypress, and Hyundai in the City of Fountain Valley. Fashion is another important industry to Orange County. Oakley, Inc., the renowned sunglasses company, is headquartered in the City of Lake Forest. Hurley Inc. is headquartered in Costa Mesa. The shoe company Pleaser USA, Inc. is located in Fullerton. St. John is headquartered in Irvine. Wet Seal is headquarted in Lake Forest. Restaurants such as Del Taco, Wahoo's Fish Tacos, Taco Bell, El Pollo Loco, In-N-Out Burger, Claim Jumper, Marie Callender's, Wienerschnitzel, have headquarters in the City of Irvine as well.
Orange County contains several notable shopping malls. Among these are the world-renowned South Coast Plaza in Costa Mesa and Fashion Island in Newport Beach. Other significant malls include the Brea Mall, The Shops at Mission Viejo, The Block at Orange, and the Irvine Spectrum Center. There is also Downtown Disney adjacent to Disneyland.
Tourism remains a vital aspect of Orange County's economy. Anaheim is the main tourist hub, with the Disneyland Resort's Magic Kingdom Park being the second most visited theme park in the country. The Anaheim Convention Center receives many major conventions throughout the year. Resorts within the Beach Cities receive visitors throughout the year due to their close proximity to the beach, biking paths, mountain hiking trails, golf courses, shopping and dining.
Tallest buildings in Orange County
|Santa Ana||One Broadway Plaza||497||37||Proposed|
|Costa Mesa||Center Tower||285||21||1985|
|Costa Mesa||Plaza Tower||282||21||1992|
|Santa Ana||Macarthur Skyline Tower 1||278||25||2009|
|Santa Ana||Macarthur Skyline Tower 2||278||25||2009|
|Irvine||Jamboree Center - 5 Park Plaza||263||19||1990|
|Irvine||Jamboree Center - 4 Park Plaza||263||19||1990|
|Irvine||Jamboree Center - 3 Park Plaza||263||19||1990|
|Irvine||Edison International Tower||263||19||N/A|
|Irvine||Opus Center Irvine II||246||14||2002|
|Irvine||Wells Fargo Center||230||18||1990|
|Orange||Doubletree Hotel Anaheim||N/A||20||1986|
|Newport Beach||The Island Hotel (Formerly the Four Seasons)||N/A||20||1986|
|Newport Beach||610 Tower||N/A||18||N/A|
|Costa Mesa||Park Tower||240||17||1979|
|Irvine||Waterfield Tower (formerly Tower 17)||220||17||1987|
|Newport Beach||660 Tower||N/A||17||N/A|
|Newport Beach||620 Tower||N/A||17||1970|
|Irvine||Irvine Marriott (Koll Center Irvine)||N/A||17||N/A|
|Anaheim||Anaheim Marriot - Palms Tower||N/A||19||N/A|
|Costa Mesa||Westin South Coast Plaza||N/A||17||N/A|
|Orange||1100 Executive Tower||210||16||N/A|
|Santa Ana||Xerox Centre||N/A||16||1988|
|Newport Beach||Marriott Newport Beach Hotel||N/A||16||N/A|
|Garden Grove||Hyatt Regency Orange County||N/A||16||1987|
|Anaheim||Anaheim Marriott - Oasis Tower||N/A||16||N/A|
|Costa Mesa||DiTech.com Tower (Two Town Center)||213||15||N/A|
|Costa Mesa||Comerica Bank Tower (Two Town Center)||213||15||N/A|
|Buena Park||Supreme Scream (amusement ride)||312||N/A||N/A|
|Anaheim||The Twilight Zone Tower of Terror (amusement ride)||183||---||2004|
|Anaheim||Anaheim Convention Center|
Arts and culture
Points of interest
The area's warm Mediterranean climate and 42 miles (68 km) of year-round beaches attract millions of tourists annually. Huntington Beach is a hot spot for sunbathing and surfing; nicknamed "Surf City, U.S.A.", it is home to many surfing competitions. "The Wedge", at the tip of The Balboa Peninsula in Newport Beach, is one of the most famous body surfing spots in the world. Other tourist destinations include the theme parks Disneyland and Disney's California Adventure in Anaheim and Knott's Berry Farm in Buena Park. Water parks in Orange County include Wild Rivers in Irvine and Soak City in Buena Park. The Anaheim Convention Center is the largest such facility on the West Coast. The old town area in the City of Orange (the traffic circle at the middle of Chapman Ave. at Glassell) still maintains its 1950s image, and appeared in the That Thing You Do! movie. Little Saigon is another notable tourist destination, being home to the largest concentration of Vietnamese people outside of Vietnam. There are also sizable Taiwanese, Chinese, and Korean communities, particularly in western Orange County. This is evident in several Asian-influenced shopping centers in Asian American hubs like the city of Irvine.
Some of the most exclusive (and expensive) neighborhoods in the U.S. are located here, many along the Orange County Coast, and some in north Orange County.
Historical points of interest include Mission San Juan Capistrano, the renowned destination of migrating swallows, and the Richard Nixon Presidential Library and Museum in Yorba Linda. The Richard Nixon Birthplace home, located on the grounds of the Presidential Library, is a National Historic Landmark. Other notable structures include the home of Madame Helena Modjeska, located in Modjeska Canyon on Santiago Creek; Ronald Reagan Federal Building and Courthouse in Santa Ana, the largest building in the county; the historic Balboa Pavilion in Newport Beach; and the Huntington Beach Pier. It is also recognized for its nationally known centers of worship, such as Crystal Cathedral in Garden Grove, the largest house of worship in California; Saddleback Church in Lake Forest, one of the largest churches in the United States; and the Calvary Chapel.
Since the premiere in fall 2003 of the hit Fox series The O.C., and the 2007 Bravo series "The Real Housewives of Orange County" tourism has increased with travelers from across the globe hoping to see the sights seen in the show. However, the former was rarely filmed anywhere in Orange County.
Orange County is also the base for several significant religious organizations:
The Vineyard Christian Fellowship movement began in Orange County.
There are about 1.04 million Catholics in Orange County.
A number of novels by best-selling fiction and horror author Dean Koontz, a resident of Newport Beach, are set in the area.
Orange County is the place in which Kim Stanley Robinson's Three Californias Trilogy is set. These books depict three different futures of Orange County (survivors of a nuclear war in The Wild Shore, a developer's dream gone mad in The Gold Coast, and an ecotopian utopia in Pacific Edge). Philip K. Dick's novel A Scanner Darkly was also set in Orange County.
From his first novel, "Laguna Heat," to more recent books such as "California Girl," mystery-writer T. Jefferson Parker has set many of his novels in Orange County.
The classic novel "Two Years Before the Mast" by Richard Henry Dana, Jr. describes journeys along the California coast in the early 1800s and the trading of goods for cow hides with the local residents. The south Orange County city of Dana Point takes its name from the author, as the cliffs around the harbor were a favorite location of his.
In popular culture
Orange County has been the setting for numerous films and television shows:
The opening scene of Gilligan's Island that shows the S.S. Minnow leaving the harbor was in Newport Beach.
It is the subject and setting of the eponymous 2002 movie Orange County. However, the film was not actually filmed in Orange County.
It is also the setting of the 2003 sitcom Arrested Development. Most of the series was not filmed in Orange County, but in Culver City and Marina del Rey in Los Angeles County. A running joke in the series that pokes fun at The O.C. is that characters will frequently refer to Orange County as "The O.C.," followed by another character's saying, "Don't call it that" (mirroring the fact that many Orange County residents do not use the term "The O.C.").
The film Better Luck Tomorrow was shot and set in the cities of Cypress and Anaheim
MTV's Life of Ryan is a reality show following the life of pro skateboarder Ryan Sheckler. The title of the show is a play on Monty Python's Life of Brian, filmed in and around the Sheckler household in San Clemente, California.
A key scene in the film Borat: Cultural Learnings of America for Make Benefit Glorious Nation of Kazakhstan was shot and set at The Block at Orange in the city of Orange.
The Christian Slater film Gleaming The Cube was set in Orange County and filmed in several cities, such as Anaheim, Woodbridge High School in Irvine, and John Wayne Airport in Santa Ana.
Sayid Jarrah from the ABC drama Lost was bound to go to Irvine, where his longtime friend Nadia lives. John Locke, another castaway from the series, is said to have lived most of his life in Tustin. Also Libby told Desmond that she is from Newport Beach.
Costa Mesa is the setting for the The X-Files episode "Hungry".
In "The Incredible Mr. Brisby" episode of The Venture Bros., Hank and Dean Venture Travel to the fictional theme park Brisby Land, a spoof on Disney Land. During the episode, radical Orange County Natives known as the Orange County Liberation Front launch a full-scale assault on the Brisby Land compound out of revenge for the ever increasing size of the Park. Members of the OCLF are easily identified by their helmets that resemble enormous oranges.
The shuttle bay scenes for the 2009 Star Trek movie were shot in the old El Toro base hangers.
Orange County has also been used as a shooting location for several films and television programs. Examples of movies at least partially shot in Orange County are Tom Hanks's That Thing You Do, the Coen Brothers' The Man Who Wasn't There, and the Martin Lawrence movie Big Momma's House. All three of which were filmed in or around the Old Towne Plaza in the City of Orange.
Huntington Beach annually plays host to the U.S. Open of Surfing, AVP Pro Beach Volleyball and Vans World Championship of Skateboarding. It was also the shooting location for Pro Beach Hockey. USA Water Polo, Inc. has moved its headquarter offices to Huntington Beach. Orange County's active outdoor culture is home to many surfers, skateboarders, mountain bikers, cyclists, climbers, hikers, kayaking, sailing and sand volleyball.
The Major League Baseball team in Orange County is the Los Angeles Angels of Anaheim, who won the World Series in 2002. In 2005, new owner Arte Moreno wanted to change the name to "Los Angeles Angels" in order to better tap into the Los Angeles media market, the second largest in the country, which includes Orange County. However, the standing agreement with the city of Anaheim demanded that they have "Anaheim" in the name, so they became the Los Angeles Angels of Anaheim. This name change was hotly disputed by the city of Anaheim and the Los Angeles Dodgers, who wanted sole possession of the title "Los Angeles," but the change stood and still stands today, which prompted a lawsuit by the city of Anaheim against Angels owner Arte Moreno, won by Moreno. It has been widely unpopular in Orange County, although attendance has increased.
The county's National Hockey League team, the Anaheim Ducks, won the 2007 Stanley Cup beating the Ottawa Senators. They also came close to winning the 2003 Stanley Cup finals after winning three games in a seven-game series against the New Jersey Devils.
The Orange County Flyers are a Golden Baseball League team based in Fullerton, California. The league is not affiliated with Major League Baseball. The Flyers were sold on March 21, 2007 to an Orange County investment group, making them the first Golden Baseball League team to ever be sold. Before their sale, the Flyers were called the Fullerton Flyers, but on March 28, 2007 they became the Orange County Flyers; they kept their team colors (blue and orange) and home games are still played at Cal State Fullerton's Goodwin Field.
The Orange County Blue Star is a USL Premier Development League soccer club. They play at Orange Coast College. Among those who have played for OCBS are Jürgen Klinsmann, the former German star and Germany's 2006 World Cup coach, who played under an assumed name.
Orange County Roller Girls - an All Female Flat Track Roller Derby League formed in 2006 and actively plays (bouts) at various locations in Orange County. Many of the league's bouts are played against teams from other cities throughout the United States.
Former and defunct Orange County sports teams
The National Football League football left the county when the Los Angeles Rams relocated to St. Louis in 1995. Anaheim city leaders are in talks with the NFL to bring a Los Angeles-area franchise to Orange County, though they are competing with other cities in and around Los Angeles.
The Los Angeles Salsa played at Cal State Fullerton's Titan Stadium in 1993–94 in the American Professional Soccer League (APSL), at the time the top soccer league in the U.S. The Salsa, whose general manager was former Cosmos star Ricky Davis and its coach former Brazil star Rildo Menezes, also played some games at East Los Angeles College in Monterey Park, California, attempting a season in Mexico's second-tier Primera A Division. That attempt was cancelled after several games when FIFA and CONCACAF ruled a club could not play in two leagues in separate countries. The Salsa lost to the Colorado Foxes in the 1993 APSL final at Cal State Fullerton.
Anaheim was also the home of the prior American Basketball Association franchise known as the Anaheim Amigos in the mid-sixties.
The Southern California Sun was an American football team based out of Anaheim that played in the World Football League in 1974 and 1975. Their records were 13–7 in 1974 and 7–5 in 1975. Their home stadium was Anaheim Stadium.
The Orange County Ramblers were a professional football team that competed in the Continental Football League from 1967-68. The Ramblers played their home games in Anaheim, California. The team was coached both seasons by Homer Beatty, who had won a small college national title at Santa Ana College in 1962.
Orange County is a chartered county of California; its seat is Santa Ana. Its legislative and executive authority is vested in a five-member Board of Supervisors. Each Supervisor is popularly elected from a regional district, and together the board oversees the activities of the county's agencies and departments and sets policy on development, public improvements, and county services. At the beginning of each year the Supervisors select a Chairman and Vice Chairman, but the administration is headed by a professional municipal manager, the County Executive. The current supervisors are Janet Nguyen, John Moorlach, Bill Campbell, and Patricia C. Bates, with a vacancy in the Fourth District, which was previously occupied by Chris Norby until he resigned to become a member of the California State Assembly.
Seven other public officials are elected at-large: the County Assessor, Auditor-Controller, Clerk-Recorder, District Attorney, Sheriff-Coroner, Treasurer-Tax Collector and Public Administrator. Since 2008, the Orange County Sheriff's Department has been led by Sheriff-Coroner Sandra Hutchens. Her predecessor, Mike Carona, resigned earlier in the year to defend himself against corruption charges.
|2008||50.4% 578,171||47.8% 548,246||1.8% 21,530|
|2004||59.7% 641,832||39.0% 419,239||1.3% 14,328|
|2000||55.8% 541,299||40.4% 391,819||3.9% 37,787|
|1996||51.7% 446,717||37.9% 327,485||10.5% 90,374|
|1992||43.9% 426,613||31.6% 306,930||24.6% 239,006|
|1988||67.7% 586,230||31.1% 269,013||1.2% 10,064|
|1984||74.7% 635,013||24.3% 206,272||1.0% 8,792|
|1980||67.9% 529,797||22.6% 176,704||9.5% 73,711|
|1976||62.2% 408,632||35.3% 232,246||2.5% 16,555|
|1972||68.3% 448,291||26.9% 176,847||4.8% 31,515|
|1968||63.1% 314,905||29.9% 148,869||7.0% 34,933|
|1964||55.9% 224,196||44.0% 176,539||0.1% 430|
|1960||60.8% 174,891||38.9% 112,007||0.2% 701|
Orange County has long been known as a Republican stronghold and has consistently sent Republican representatives to the state and federal legislatures. Republican majorities in Orange County helped deliver California's electoral votes to Republican presidential candidates Richard Nixon (1960, 1968 and 1972), Gerald Ford (1976), Ronald Reagan (1980, 1984), and George H. W. Bush (1988). Orange County has not voted for a Democratic presidential candidate since Franklin D. Roosevelt's 1936 landslide re-election for a second term. Although Democrats have made inroads in the northern end of the county since the mid-1980s, Orange County politics are still dominated by Republicans. Five of the county's six U.S. Representatives, four of its five State Senators and seven of its nine State Assemblymembers are Republicans, as are all five members of the County Board of Supervisors. Only four Democrats have carried the county in a statewide race in the last 50 years; Jerry Brown in his successful campaign for Governor in 1978, March Fong Eu for Secretary of State and Kenneth Cory for State Controller, both also in 1978 and Kathleen Connell for Controller in 1998.
In Congress, representatives whose districts are completely or partially in the county include Republicans Ed Royce (CA-40), Gary Miller (CA-42), Ken Calvert (CA-44), Dana Rohrabacher (CA-46), and John Campbell (CA-48), and Democrat Loretta Sanchez (CA-47). In the State Senate, Senators whose districts are completely or partially in the county include Republicans Bob Huff (SD-29), Mimi Walters (SD-33), Tom Harman (SD-35), and Mark Wyland (SD-38), and Democrat Lou Correa (SD-34). In the State Assembly, Assemblymembers whose districts are completely or partially in the county include Republicans Curt Hagman (AD-60), Jim Silva (AD-67), Van Tran (AD-68), Chuck DeVore (AD-70), Jeff Miller (AD-71), Chris Norby (AD-72), and Diane Harkey (AD-73), and Democrats Tony Mendoza (AD-56) and Jose Solorio (AD-69).
According to the Orange County Registrar of Voters, as of July 21, 2009, Orange County had 1,599,889 registered voters. Of these, 43.6% (698,140) are registered Republicans, and 32.1% (512,853) are registered Democrats. An additional 20.2% (324,669) declined to state a political party.
Orange County has produced such notable Republicans as President Richard Nixon (born in Yorba Linda and lived in San Clemente), U.S. Senator John F. Seymour (previously mayor of Anaheim), and U.S. Senator Thomas Kuchel (of Anaheim). Former Congressman Chris Cox (of Newport Beach), a White House counsel for President Ronald Reagan, is also a former chairman of the U.S. Securities and Exchange Commission. Orange County was also home to former Republican Congressman John G. Schmitz, a presidential candidate in 1972 from the ultra-conservative American Independent Party and the father of Mary Kay Letourneau. In 1996, Curt Pringle (currently mayor of Anaheim) became the first Republican-elected Speaker of the California State Assembly in decades.
While the growth of the county's Hispanic and Asian populations in recent decades has significantly influenced the culture of Orange County, its conservative reputation has remained largely intact. Partisan voter registration patterns of Hispanics, Asians and other ethnic minorities in the county have tended to reflect the surrounding demographics, with resultant Republican majorities in all but the central portion of the county. When Democrat Loretta Sanchez defeated veteran Republican Bob Dornan in the congressional contest of 1996, she was continuing a trend of Democratic representation of that district that had been interrupted by Dornan's 1984 upset of former Congressman Jerry Patterson. Until 1992, Sanchez herself was a Republican, and she is viewed as having moderate or even conservative positions on many issues.
Republicans have responded to the influx of non-white immigrants by making more explicit efforts to court the Hispanic and Asian vote. In 2004, George W. Bush captured 60% of the county's vote, up from 56% in 2000, despite a higher Democratic popular vote compared with the 2000 election. Although Barbara Boxer won statewide, and fared better in Orange County than she did in 1998, Republican Bill Jones defeated her in the county, 51% to 43%. While the 39% that John Kerry received is higher than the percentage Bill Clinton won in both 1992 and 1996, the percentage of the vote George W. Bush received in 2004 (59.7% of the vote) is the highest any presidential candidate has received since 1988, showing a still-dominant GOP presence in the county. In 2006, Senator Dianne Feinstein won 45% of the vote in the county, the highest margin of a Democrat in a Senate race in over four decades, but Orange was nevertheless the only Coastal California county to vote for her Republican opponent Dick Mountjoy. In terms of voter registration, the Democratic Party has a plurality or majority of registrations only in the cities of Santa Ana, Stanton, and Buena Park.
The county is featured prominently in the book Suburban Warriors: The Origins of the New American Right by Lisa McGirr. She argues that the county's conservative political orientation in the 20th century owed much to its settlement by Midwestern transplants, who reacted strongly to communist sympathies, the civil rights movement, and the turmoil of the 1960s in nearby Los Angeles — across the "Orange Curtain".
In the 1970s and 1980s, Orange County was one of California's leading Republican voting blocs and a sub-culture of residents to hold "Middle American" values that emphasized a capitalist religious morality in contrast to West coast liberalism that well existed there.
Orange County has a high portion of Republican voters from culturally conservative Asian-American, Middle Eastern and Latino immigrants. Some of these came as refugees from wars and dictatorships, and are strongly loyal to Republican anti-communist policies. The large Vietnamese-American communities in Garden Grove and Westminster are predominantly Republican; Vietnamese Americans registered Republicans outnumber those registered as Democrats by 55% to 22%. Republican Assemblyman Van Tran was elected to become the first Vietnamese-American to serve in a state legislature and joined with Texan Hubert Vo as the highest-ranking elected Vietnamese-American in the United States prior to the 2008 election of Joseph Cao in Louisiana's Second Congressional District. In the 2007 special election for the vacant county supervisor seat following Democrat Lou Correa's election to the state senate, two Vietnamese-American Republican candidates topped the list of 10 candidates, separated from each other by only seven votes, making the Board of Supervisors entirely Republican.
Orange County is the home of many colleges and universities, including:
The Orange County Department of Education oversees 28 school districts.
The county is primarily served by The Orange County Register. OC Weekly is an alternative weekly publication and Excélsior is a Spanish-language newspaper. A few communities are served by the Los Angeles Times' publication of the Daily Pilot, the Huntington Beach Independent and the Laguna Beach Coastline Pilot. OC Music Magazine is also based out of Orange County, serving local musicians and artists.
Orange County is served by radio stations from the Los Angeles area. There are a few radio stations that are actually located in Orange County. KJLL-FM 92.7 has an adult contemporary format. KSBR 88.5 FM airs a jazz music format branded as "Jazz-FM" along with news programming. KUCI 88.9FM is a free form college radio station that broadcasts from UC Irvine. KWIZ 96.7 FM, located in Santa Ana, airs a regional Mexican music format branded as "La Rockola 96.7". KWVE-FM 107.9 is owned by the Calvary Chapel of Costa Mesa. KWVE-FM is also the primary Emergency Alert System station for the county. The Los Angeles Angels of Anaheim also own and operate a sports-only radio station from Orange, KLAA.
Notable natives and residents
Due to Orange County's proximity to Los Angeles, the entertainment capital of the United States, many film and media celebrities have moved or bought second homes in the county. Actor John Wayne, who lived in Newport Beach, is the namesake for Orange County's John Wayne Airport. Orange County has also produced many homegrown celebrities, including musician Jeffree Star, golfer Tiger Woods, musician Andrew McMahon, basketball players Dennis Rodman and Kobe Bryant, a number of professional ballplayers, including retired slugger Mark McGwire, WWE Wrestler, Chavo Guerrero Jr. actor, Kevin Costner, comedian/actors Steve Martin and Will Ferrell, actresses Michelle Pfeiffer and Diane Keaton, and singers Chester Bennington, Bonnie Raitt, Gwen Stefani, Jeff Buckley, Marc Cherry, Drake Bell and Major League Ballhawk John Witt. Ms. America Susan Jeske is also a resident. Avenged Sevenfold, Lit, No Doubt, Social Distortion, The Offspring, Atreyu and Leo Fender (the inventor of the first commercially successful solid body electric guitars) also call Orange County home.
The county's most famous resident was perhaps Richard Nixon, the 37th President of the United States, who was born in Yorba Linda and lived in San Clemente for several years following his resignation. His presidential library is in Yorba Linda.
AGENCIES ORANGE COUNTY, HOME CARE, HOSPICE, RESPITE
"We Care Like Family"
do you become famous? Helping people! Changing their lives and making
a difference in their lives.
Loving them... Eric Brenn
Viejo 92656, 92698,
Anaheim 92801, 92802, 92803, 92804, 92805, 92806, 92807, 92808, 92809, 92812, 92814, 92815, 92816, 92817, 92825, 92850, 92899,
Brea, 92821, 92822,92823,
Buena Park, 90620 ,90621,90622, 90624, Capistrano Beach, 92624,
Corona del Mar, 92625,
Costa Mesa, 92626, 92627, 92628,
Dana Point, 92629,
East Irvine, 92650,
El Toro, 92609,
Foothill Ranch, 92610,
Fountain Valley, 92708, 92728,
Fullerton, 92831, 92832, 92833, 92834, 92835, 92836, 92837, 92838,
Garden Grove, 92840, 92841, 92842, 92843 ,92844, 92845, 92846,
Huntington Beach , 92605, 92615, 92646, 92647, 92648, 92649,
Irvine, 92602, 92603, 92604, 92606, 92612, 92614, 92616, 92617, 92618, 92619, 92620, 92623, 92697,
La Habra, 90631, 90632, 90633,
La Palma, 90623,
Ladera Ranch, 92694,
Laguna Beach , 92651, 92652,
Laguna Hills ,92653, 92654,92607,92677,
Laguna Woods, 92637,
Lake Forest, 92630,
Los Alamitos, 90720, 90721,
Midway City, 92655,
Mission Viejo, 92690, 92691, 92692,
Newport Beach , 92658, 92659, 92660, 92661, 92662, 92663, 92657,
Orange, 92856, 92857, 92859, 92862, 92863, 92864, 92865, 92866, 92867, 92868, 92869, Placentia, 92870, 92871,
Rancho Santa Margarita 92688,
San Clemente, 92672, 92673, 92674,
San Juan Capistrano, 92675, 92693,
Santa Ana , 92701, 92702, 92703, 92704, 92705 ,92706, 92707, 92711, 92712, 92725.92735, 92799,
Seal Beach , 90740,
Sunset Beach 90742,
Trabuco Canyon, 92678, 92679,
Tustin ,92780, 92781,92782,
Villa Park, 92861,
Westminster, 92683, 92684, 92685,
Yorba Linda, 92885, 92886, 92887