Home Health Care

Home health-care workers in US at tipping point amid coronavirus outbreak

caregiver with elderly man

Published Tue, Apr 14 2020 8:51 AM on CNBC by Bob Woods
Read the Full Article on CNBC >

The nation’s 3.3 million home health-care workers are the other front-line heroes in the war against the coronavirus. While hospitals’ physicians and nurses tend to the sickest COVID-19 victims, the in-home workforce is caring for millions of the most vulnerable Americans.

Yet they lack personal protective equipment, too. According to a March survey of 1,200 in-home workers by the Home Care Association of America, 77% don’t have enough masks and 57% don’t have enough gloves. Many are underpaid and lack health insurance and paid sick leave. The pandemic is putting additional pressure on a workforce already in crisis suffering from shortages, especially in hard-hit states such as New York, New Jersey, Louisiana and Washington.  In response, the largest home health-care union, industry providers and advocacy groups are urging Washington to respond to this crisis.

Home health workers — comprising nurses, therapists and personal care aides — provide a range of medical and daily-living services to nearly 12 million people, most of them elderly and many chronically ill, disabled, bedridden or coping with Alzheimer’s disease and other cognitive issues. And while they are a critical link in fighting this deadly pandemic, they’re overlooked in daily briefings by the White House Coronavirus Task Force and ubiquitous media reports.

“We have boots on the ground today, out there in people’s homes for three to six hours a day, caring for folks who are most at risk,” said Vicki Hoak, executive director of HCAOA, a Washington, D.C.-based trade group representing nearly 3,000 companies that employ more than 500,000 caregivers across the U.S. “Our mantra over the past few weeks has been protect and prevent.”

That this workforce toils unheralded is surprising, considering that stressed hospitals are discharging noncritical patients and postponing elective surgeries to make room for mounting COVID-19 cases. And that skilled nursing facilities and assisted-living communities are losing residents because of widespread infections and visiting restrictions on families.

Suddenly, private homes are the go-to refuges for both medical and personal care. But unless family members can provide for this influx of patients, home-care workers will be the best solution, heaping an exponential burden onto an already stressed profession.

The private and public entities — such as Home Instead Senior Care and California’s In-Home Supportive Services program — that employ in-home caregivers are rapidly responding to the fast-rising demand, even as some workers are forced to stay home to care for their own families, clients cancel visits for fear of becoming infected and the paucity of personal protective equipment lurks.

Home health workers on the front lines

It’s a crisis at a tipping point. The work of these caregivers may never have been more vital than right now, yet worker shortages are a real threat.

Once the pandemic hit the U.S., the home health-care industry immediately began preparing its workers to add coronavirus to their already full plates. They launched education and training programs, provided as much PPE as possible and stepped up telehealth services.

“I mandated that our global franchise network retrain and recertify all our caregivers on basics like washing hands, avoiding touching their face, avoid contact with people who are sick, and if you’re sick to stay home,” said Jeff Huber, CEO of Home Instead, a private company based in Omaha, with more than 1,000 independent franchises.

Home Instead established a coronavirus task force to disseminate essential information, materials and resources for franchisees and their caregivers. “The front line has everything at their fingertips,” Huber said.

Kindred at Home, based in Atlanta, has taken a similar approach with its 779-community care, home health and hospice operations across 40 states. “We have provided a comprehensive document detailing the coronavirus, its signs and symptoms and patient risk assessment, as well as staff and patient education resources,” said COO Nick Stengle.

“The challenge for our caregivers is making sure they can do their work safely,” said Sterling Harders, president of the Service Employees Union International 775, which represents 45,000 health-care workers, including 42,000 in-home personal-care aides, in Washington state and Montana. “They are providing what oftentimes is very intimate care that is difficult to do while social distancing from 6 ft away.”

SEIU Healthcare — the largest division of the union, representing nearly 1.1 million health-care workers, 740,000 of whom provide non-medical care in homes — is keeping members up to speed on coronavirus through local chapters in about a dozen states. SEIU 775, for example, is regularly sending updates via email and social media. “We also have a call center that’s able to field calls in over a dozen languages,” Harders reported, alluding to the ethnic diversity among not just its members but the home health-care workforce overall.

In California, SEIU Local 2015 has a comparable outreach for its 400,000 health-care workers, 380,000 of whom work mostly for IHSS. “PPE is the first thing on our members’ minds,” said chapter president April Verrett, “because they want to continue going into homes but don’t want to get sick” or risk infecting households. SEIU 2015 workers have adequate supplies of antibacterial soap and hand sanitizer, she said, but not sufficient PPE.

Risks to caregivers and patients rise

The risks to in-home caregivers extends beyond the scarcity of PPE to screening for coronavirus, said William Dombi, president of the National Association for Home Care and Hospice, a Washington-based industry advocate mostly for nurses, therapists and other medically trained in-home workers. “I can’t speak for every location and employer,” he said, “but the protocol under way is for screening of every worker before going into the home, so they don’t create a risk for their clients, and it’s also screening clients to see that there’s no risk to the workers.”

Even so, according to the HCAOA survey, nearly 90% of respondents reported clients canceling one or more visits, because they fear aides may spread the disease. Despite those worries, however, 80% said that no clients or employees had reported COVID-19 symptoms.

This overlap of fear and precaution is impacting in-home caregiving. “We’ve been hearing about numerous cases where providers are scrambling to find workers,” said Robert Espinoza, vice president of policy at PHI, a Bronx-based nonprofit that advocates for home health workers, though shortages are hard to gauge, because states don’t collect enough data on direct care workers.

“We have been hearing from some agencies that they have had a slight decline in workers, as well as clients,” HCAOA’s Hoak said. Kindred reported fewer patient visits, but not a shortage of workers.

It’s been a mixed bag for Home Instead. “We’ve seen some clients not needing as much care, due to family being home from work,” a company spokesperson said. “But on the other side of the spectrum, we have new clients starting care at home, including those in heavily impacted areas where seniors are being discharged for non-COVID-19-related illness to free up hospital beds.”

Those developments help explain the dramatic expansion of in-home telehealth. The technology allowing patients to remotely connect by voice and video with medical practitioners via smartphones, computers and tablets has been around for years, but the coronavirus pandemic is fueling a meteoric rise in usage.

Coronavirus makes telehealth key

“We’ve never seen anything like this,” said Mike Baird, president of customer solutions at Amwell, a Boston-based telehealth services and technology company. “Overall, our volumes of engagement are up sevenfold from where they were in peak flu season just a few weeks ago.” Amwell customers that were seeing a few hundred patients per week just one week ago are now seeing 1,000 or more per day, with notable activity in hard-hit states including Washington, New York, New Jersey and Louisiana.

Amwell works with more than 2,400 hospitals, 240 health systems and 55 health insurance plans, with about 85% of its telehealth services going to in-home patients. “Our in-home volume is so big due to the influx of patients being told by hospitals, health systems and primary care providers not come in, because they don’t have the tests or capability to do assessments,” Baird said. “In contrast, we have a network of more than 10,000 doctors available on demand.”

Two years ago Home Instead made a strategic investment in GrandPad, an Orange, California-based maker of a proprietary telehealth tablet designed for seniors. “It’s an effective tool not just for clients but for our in-home caregivers,” Huber said. “When we’re not there, it allows us to do virtual check-ins, quality assurance visits and reduce the amount of time we [risk] being in homes.”

Not all health insurance plans offer telehealth, but the federal Centers for Medicare and Medicaid Services recently announced some reimbursement expansions, but only during the coronavirus crisis. “Telehealth is an essential focus of our advocacy efforts,” Dombi said. “We’re hoping to see more coming from CMS” in the near future, especially regarding in-home access and reimbursements.

Industry reforms needed

This moment, too, is a fortuitous occasion to shine a bright light on the need to address long-overdue reforms in the home care industry. “We look for historical and political moments where everything we advocate for rises to the highest level,” Espinoza said. “This crisis shows people what it means to have a disenfranchised workforce.”

Nearly 90% of home health-care workers are women, and their median age is 46, according to PHI. More than 60% are people of color, 31% are immigrants, and half have no formal education beyond high school. Only about a third of the workforce unionized.

According to the latest analysis by the federal Bureau of Labor Statistics, median annual pay was $24,060 in 2018, or $11.57 per hour. Overall employment of home health aides and personal-care aides — as BLS categorizes the workforce — is projected to grow 36% from 2018 to 2028, adding a total of 4,438,700 new jobs over the decade, per the agency.

The coronavirus crisis is putting additional stress on a workforce that was already facing shortages due to the aging of America. With nearly 10,000 baby boomers turning 65 every day — a population including millions of individuals already living with long-term health conditions or likely to develop one or more — and the growing trend of aging in place, experts have been warning that the demand for in-home care is outpacing the supply of both medical practitioners and care aides.

But even now, as the urgent need for home health care is clear, there’s little focus in Washington, D.C., on this looming dilemma. Some short-term loosening of regulatory and reimbursement burdens have been implemented by the Centers for Medicare and Medicaid Services, but advocates insist that permanent fixes must be addressed once the coronavirus crisis abates.

“For years we’ve been advocating for stronger training programs across the board, but especially for personal care aides,” Espinoza said. “This is a great example of what it means when we don’t train them right, that they’re not prepared to deal with something of this scale.”

The National Domestic Workers Alliance, based in New York, is pushing for better pay, benefits and rights for home care workers, as well as nannies and house cleaners. “Our increasing need for [home] care will remain even when the coronavirus has passed,” said executive director Ai-jen Poo. “The reasons to protect domestic workers and make sure that care jobs are good jobs are now stark.”

 If nothing else, the COVID-19 crisis offers a timely opportunity to recruit home care workers to fill the dwindling pipeline. “The [tight] labor market has been a restriction on our growth,” Huber said. “A lot of our owners are ramping up their recruitment efforts to target people from other industries who are out of work.”

No matter where they come from, now is the time to consider this noble career, Harders said. “With all of these people aging and needing care and not having enough caregivers, this is a great opportunity for folks to give it a try.”

This story has been updated to reflect that Kindred At Home is based in Atlanta, not Louisville, and is a standalone company owned 40% by Humana.

The hidden role informal caregivers play in health care

Scott Williams Ted Talk

Scott Williams | TED@Merck KGaA, Darmstadt, Germany | November 2017

Once a cared-for patient and now a caregiver himself, Scott Williams highlights the invaluable role of informal caregivers — those friends and relatives who, out of love, go the extra mile for patients in need. From personal care to advocacy to emotional support, unpaid caregivers form the invisible backbone of health and social systems all over the world, Williams says — and without them, these systems would crumble. “How can we make sure that their value to patients and society is recognized?” he asks.

Watch on Ted.com >

This talk was presented at a TED Institute event given in partnership with Merck KGaA, Darmstadt, Germany. TED editors featured it among our selections on the home page. Read more about the TED Institute.

Successful Aging: Finding the right caregiver

A young hand holding an elderly pair of hands

Q: My parents are living with significant limitations from severe arthritis, macular degeneration, recent surgeries, plus the beginning of cognitive problems. My brother and I live out of town and have been alternating weekdays and weekends tending to their needs and managing their full-time care providers — some of whom are not great. Despite our well-intentioned advice for them to move, they won’t even consider it. There is an assisted-living facility near where my brother and I live. The stress, wear and tear on us is huge. Add to this the financial drain. We need help. — A.A.

A: You do have a problem, and are not alone. Here are a few facts from the Family Caregiver Alliance:

• 43.5 million adult family caregivers care for someone 50 years old or older.

• The average age of a caregiver is 48 years, with 43 percent living alone.

• 10 million caregivers over 50 who care for their parents lose an estimated $3 billion in lost wages, pensions, retirement funds and benefits.

• Absenteeism caused by caregiving responsibilities cost the U.S. economy an estimated $25.2 billion in lost productivity.

• Eleven to 17 percent of caregivers (depending on what you read) have reported their health has gotten worse as a result of providing care.

Although you and your brother are not full-time on-site caregivers, the long-term physical and emotional stress you may be experiencing are risk factors to your well-being.

Here’s a recommended partial solution: Hire a professional geriatric care manager. This person typically comes from various fields of human services such as social work, psychology, nursing and gerontology. The individual is trained to assess, plan, coordinate, monitor and provide services to older family members and their families.

How do you know if you need a care manager? If you and your brother are overwhelmed, it might be time. Other reasons: A family member has multiple medical and psychological issues and is unable to live safely in the current environment. Add to this list: caregiver burnout, needed resources, inadequate current care and responsible family member(s) living out of town.

Assuming you decide a care manager is needed, the next step is the interview. Here are some questions recommended by the National Association of Professional Geriatric Care Managers:

• What services do you provide, or what services does your agency provide?

• If you are with an agency, how many geriatric care managers are in your agency/business?

• We would like an initial consultation, is there a fee and, if so, how much?

• Are you licensed in your profession? If so, describe your professional credentials.

• Are you a member of the National Association of Professional Geriatric Care Managers?

• How long have you been providing care-management services?

• If an emergency occurs, are you available?

• Do you or your company also provide individuals who will come into the home on a regular basis and provide hands-on care?

• In what way(s) do you communicate information with the family, caregivers and the care receiver?

• Is there a live person with whom I can speak? Is he or she available on Sundays and after business hours?

• What are your fees? (This is important before any services are rendered.)

• Can you provide a few references?

Be sure you like the person you are hiring; chemistry is important.

Once you’ve made the decision to hire, request the engagement in writing. The document should include services the care manager will perform and the fees. Know how fees are computed, how travel time and mileage are handled and how services are terminated if needed.

To find a professional certified geriatric care manager, go to www.caremanager.org and enter a zip code. Certification means the geriatric care manager has met certain standards of education, has had supervised experience and adheres to a code of ethics.

For those not yet facing issues of elder care, you might consider slipping this column into a folder for future use, for good reason.

Former first lady Rosalynn Carter said it well: “There are only four kinds of people in the world: Those who have been caregivers, those who currently are caregivers, those who will be caregivers and those who will need caregivers.”

Thank you, A.A., for your important question. My best wishes to you and your brother in finding the best care manager and subsequent care for your parents.

Source:  Press Telegram

Alzheimer’s Hits Women Hardest

Angie and John

Women are carrying the bigger burden of Alzheimer’s disease in the U.S., according to a new report — making up not only most of the cases, but paying more of the cost of caring for the growing population of people with the mind-destroying illness.

The new report from the Alzheimer’s Association paints Alzheimer’s as a disease that disproportionately affects women, both as patients and as caregivers. It points out that women in their 60s are about twice as likely to develop Alzheimer’s over the rest of their lives as they are to develop breast cancer.

“So women are at the epicenter of Alzheimer’s disease today, not only by being most likely to be diagnosed with Alzheimer’s, but also by being the caregiver most of the time,” said Maria Carrillo, vice president of the advocacy group.

Alzheimer’s affects more than 5 million Americans, a number projected to soar to 13 million over the next 35 years. A study published earlier this year suggested it’s a big killer, taking down more than 500,000 Americans every year.

Angie Carrillo and John Wallace didn’t expect that he’d develop early onset Alzheimer’s

Three out of five of those living with Alzheimer’s are women, the report finds. “The surprising statistic we pulled out of this report actually is that women over 65 have a one in six chance of developing Alzheimer’s disease, in comparison to one out of 11 in men,” Carrillo said. And that compares to a one in eight lifetime risk for developing breast cancer.

“John and I had a whole plan. And all of a sudden, that was not going to happen.”

Even if they escape the disease themselves, women often are burdened in another way, by having to care for afflicted loved ones. There are more than twice as many women as men taking care of someone with Alzheimer’s all day, every day, the report finds.

One of them is Angie Carrillo of San Jose, Calif. Carrillo — no relation to Maria Carrillo — was stunned when her then-61-year-old husband, John Wallace, was diagnosed with Alzheimer’s in 2008. Things went downhill quickly and Wallace, an accountant, lost his job.

“John and I had a whole plan. And all of a sudden, that was not going to happen,” Carrillo, now 61 herself, told NBC News.

“He had long-term disability, but in order to qualify for that, you had to be disabled for 90 days. So for 90 days, we didn’t have his income, and not that we were living large, but we were spending our paycheck.”

They had to dip into retirement savings.

“It was a scramble to keep my job, go to all of these doctor’s appointments to verify that John indeed was disabled,” Carrillo added.

It’s a pattern the Alzheimer’s Association sees across the country.

The report finds that 20 percent of women cut their working hours from full-time to part-time while caring for someone with Alzheimer’s, while just 3 percent of men did. Federal survey data show that 65 percent of caregivers for patients with dementia are women.

The group analyzed data from federal health surveys, the Census Bureau, National Alliance for Caregiving, AARP and its own poll of 3,000 people to show that 18 percent of women have taken a leave of absence to care for someone with Alzheimer’s, and 11 percent of men have. Eleven percent of women say they have quit their jobs, while 5 percent of men have. Ten percent of women say they’ve lost job benefits because of time taken to care for an Alzheimer’s patient.

“It was a scramble to keep my job.”

And at the same time, they’ve often lost income from a disabled spouse.

“We’re still dipping into our retirement funds,” Carrillo said. “Someone told me, ‘You need to go talk to a good CPA’ and I said, ‘I have a good CPA. Unfortunately, he has dementia’,” Carrillo said.

The disease also hits family life, including grandchildren. “We were the family hub,” Carrillo remembers. “All of the birthdays happened here, all of the holidays … we had six grandchildren sleeping in the den.”

Like millions of U.S. women, Angie Carrillo struggles to care for a loved one with Alzheimer’s disease: her husband, John Wallace.

Dementia changed that. “It went from a really happy place to a place that’s not so happy. Papa all of a sudden wasn’t able to drive a car and take them to the skate park … or to go play miniature golf with them … so our life became smaller and smaller,” she said.

This can leave women feeling alone, the report finds. “The higher care giving burden placed on women has many consequences, including higher emotional and physical stress, strained family relationships and lost employment opportunities,” it concludes.

Carrillo eventually had to put Wallace into a full-time care facility. He would wander and get lost and couldn’t be left alone for a moment.

“The memory care facility he’s in now is $5,000 a month,” Carrillo said Carrillo, who blogs about her situation.

“I don’t quite know where I’m going to get that money,” she added. “So I’m in the process right now of creating a rental space in my home.”

Medicaid will help, but only once Carrillo is broke. And that often happens, the report finds.

“Given the high average costs of these services (adult day services, $72 per day; assisted living, $43,756 per year; and nursing home care, $83,230 to $92,977 per year), individuals often deplete their income and assets and eventually qualify for Medicaid,” the report reads. “Medicaid is the only public program that covers the long nursing home stays that most people with dementia require in the late stages of their illnesses.”

The Alzheimer’s Association says the total national cost of caring for people with Alzheimer’s and other dementias is projected to reach $214 billion this year. The report calculates that unpaid caregiving by family and friends would add up to another $220 billion.

“In 2014, the cost to Medicare and Medicaid of caring for those with Alzheimer’s and other dementias will reach a combined $150 billion with Medicare spending nearly $1 in every $5 on people with Alzheimer’s or another dementia,” the association says.

Right now, there are no good treatments for Alzheimer’s and certainly nothing even close to a cure. The biggest advance lately is a blood test that appears to show who’s likely to develop symptoms — but researchers say all that really does is provide a way for people to prepare for the inevitable, and perhaps for their doctors to try treating them earlier to see if current less-than-useful medications might do better in someone who hasn’t begun to show memory loss yet.

“Despite being the nation’s biggest health threat, Alzheimer’s disease is still largely misunderstood. Everyone with a brain — male or female, family history or not — is at risk for Alzheimer’s,” said Angela Geiger, chief strategy officer of the Alzheimer’s Association.

Although millions of Americans are in the same situation as Carrillo, “It’s a lonely journey,” she said.

Source:  NBC News First published March 18th 2014, 9:01 pm

‘a lifetime of happiness is awaiting you…’

Lara and Erin with Grandmother

I’m going to be honest. There was a time in my life where I wasn’t so happy. I was satisfied, because I really did have everything I needed, but I wasn’t happy. And I’m not sure if there was even a life-shattering event that took place which made me become a truly happy person. But I do know this — I am the happiest now I have ever been.

For the past five years, I have seemed to build an empire of happiness around me. I have surrounded myself with happy people, which means selectively choosing my friends and acquaintances. I don’t allow negativity into my space — whether that is my mental space, my physical space or my emotional space. I have learned how to be so in tune with myself that when something is making me unhappy, I take time to reflect on it, meditate and explore the circumstances surrounding the emotion, instead of pushing it aside and burying it. And above all, I have learned to be present and find joy in the smallest aspects of life, from a cicada that made a racket outside my window this week to the elderly man I say hello to while walking past his Brooklyn stoop each morning. (He doesn’t ever respond, but I know he hears me, as he gives me the slightest head nod.)

When I sat down to write this article though, I became stuck in the writing journey because I had never thought about how I had built this empire of happiness. So, I laced up my running shoes and went for a run, because running is what gets me unstuck when I have a writing project that just doesn’t seem to be flowing.

I took off around the block and headed toward my neighborhood park. I decided in mid-stride that I would take some time to reflect on this topic underneath my favorite tree in Brooklyn. It is an oak tree which is about 80 years old, with a thick curved branch perfect for sitting on or hanging from. And when I arrived at the tree for my mid-run stretch, I said aloud, “How do you build an empire of happiness?”

Read more‘a lifetime of happiness is awaiting you…’

The Powerful Benefits of Family Support

Family with grandfather

“The family is one of nature’s masterpieces.”-George Santayana, philosopher, poet, novelist

An Inspiring New Beginning

A couple of months ago, Little Lotus and I moved to live near members of our family. Upon moving closer to my aunt, uncle, and a bunch of cousins, I immediately began to understand the support system I’d been missing. I can’t tell you how wonderful it is to be surrounded by family who see my potential, encourage me to take time for myself, and who I trust to take excellent care of my daughter. The support of my family inspires me to do my best, and I’m excited that my daughter will reap the benefits of family support as she grows.

The Benefits of Family Support

The well known African proverb, “It takes a whole village to raise a child,” resonates with so many people for good reason. The support of a loving family and community is essential, and it offers several vital benefits like:

  • Enhanced self-esteem and identity.
  • Members see the importance of their role in the group or the bigger picture.
  • Shared legacy and culture.
  • A sense of belonging, acceptance, and connectedness.
  • Shared caretaking responsibilities of children and elders.
  • Greater financial security through shared resources.

Remembering Where I Come From

In the short time I’ve lived near my family, I’ve been reminded of the strong line of people I come from and recognized my place in a long line of feisty, capable, big-hearted women. I’ve had a blast getting together with my cousins and their children (my little cousins) for play dates and parties, and I’ve loved being able to have a moment to myself knowing that my daughter is in good hands. I have always strived, but now I feel even more supported to spread my wings.

“Family traditions counter alienation and confusion. They help us define who we are; they provide something steady, reliable and safe in a confusing world.”-Susan Lieberman, author New Traditions

“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter” Mark Twain

Elderly Couple Laughing

Laughter can be a powerful anti-aging weapon. And the most wonderful thing about it, is that it it’s free and available to everyone.

There is nothing in life that can keep you young at heart like a good laugh. Whether laughing over a shared memory with a close friend, watching a movie, reading a book, or forcing a laugh to ward off a bad mood, a good laugh can boost your attitude and leave you in a happier state of mind.

Laughter promotes relaxation, it relievers stress and releases tension from the neck and shoulders, and it promotes the release of endorphins, the ‘feel-good’ hormones.

“You don’t stop laughing because you’re old. You grow old because you stop laughing”

Read more“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter” Mark Twain

Home Health Care Needs

caregiver holding cast
We Can Help Managing Your Life During Treatment

Some cancer patients require specialized health care assistance. This might happen during or after cancer treatment. Home health care services can provide certain types of temporary or ongoing medical care at home. The goal is to make it possible to remain safe and comfortable at home while having a good quality of life.

A member of your health care team might suggest adding home health care services to your treatment plan. This type of care is usually less expensive than care provided in a medical facility, but you will still have access to hospitals or other health care facilities.

Read moreHome Health Care Needs

Home Care for Cancer Patients

Hand carrying candle
  1. Why do some cancer patients choose home care?Cancer patients often feel more comfortable and secure being cared for at home. Many patients want to stay at home so they will not be separated from family, friends, and familiar surroundings. Home care can help patients achieve this desire. It often involves a team approach that includes doctors, nurses, social workers, physical therapists, family members, and others.Home care can be both rewarding and demanding for patients and caregivers. It can change relationships and require families to address new issues and cope with all aspects of patient care. To help prepare for these changes, patients and caregivers are encouraged to ask questions and get as much information as possible from the home care team or organizations devoted to home care. A doctor, nurse, or social worker can provide information about a patient’s specific needs, the availability of home care services, and a list of local home care agencies.

    Read moreHome Care for Cancer Patients

The Right Way to Find Home Care for a Senior

caregiver helping elderly woman with breakfast

An adult child who is caring for an aging parent may suddenly find that the job of caregiving is too much to handle. The senior parent, who is living at home, may abruptly need someone with them during longer periods of the day and night, or the senior may require skilled personnel. In this situation, the adult child often seeks a person to provide home health care assistance.

Assessing the type of home care a senior parent needs   To determine the kind of home care that is essential for the senior, the adult child can first observe the senior parent. Watch how the senior handles routine Activities of Daily Living (ADLs) such as bathing and dressing. Also, note any housekeeping or errands that are difficult for the senior to accomplish. Make a list of all of the areas that the senior requires help, or if the senior had assistance, where their life would be better.

The Family Caregiver Alliance offers these guidelines for assessing the home care needs of a senior and for indicating where the caregiver needs support:

  • Personal Care: bathing, eating, dressing, toileting
  • Household Care: cooking, cleaning, laundry, shopping
  • Health Care: medication management, physician’s appointments, physical therapy
  • Emotional Care: companionship, meaningful activities, conversation

By assessing each area, the adult child can begin to align support for each need. For example, a friend or neighbor may be able to cover some of the areas of need, or community services, such as Meals on Wheels, can offer aid with other care requirements. If the senior parent has medical needs or requires constant supervision, hiring a home care worker is a viable alternative.

Sure-fire warning signs that a senior needs more help Agingcare.com suggests that if an adult child or caregiver notices certain warning signs, the senior probably requires assistance on a more regular basis. Some signs to look for are:

  • Spoiled food that doesn’t get thrown away
  • Missing important appointments
  • Difficulty with walking, balance and mobility
  • Uncertainty and confusion when performing once-familiar tasks
  • Forgetfulness
  • Unpleasant body odor or noticeable decline in grooming habits and personal care
  • Dirty house, extreme clutter and dirty laundry piling up
  • Stacks of unopened mail or an overflowing mailbox
  • Late payment notices, bounced checks and calls from bill collectors
  • Poor diet or weight loss
  • Loss of interest in hobbies and activities
  • Changes in mood or extreme mood swings
  • Forgetting to take medications – or taking more than the prescribed dosage
  • Diagnosis of dementia or early onset Alzheimer’s
  • Unexplained dents and scratches on a car

Where to start looking for home care Once it is apparent that the senior needs a home care worker or a home health care worker to help them around the house, locating the appropriate individual may present a challenge. Begin by asking people and organizations in the community – friends, local clergy, geriatric care managers or hospitals – if they could recommend a home care worker or a reputable home care agency. Community and local government resources, such as the local Area Agency on Aging, can often give advice on many good options for in-home care. The Eldercare Locator is a great federal resource.

Whether you’re planning to enlist the help of a home care services agency or hire a personal home health aide, knowing what questions to ask is key to receiving quality assistance. The Society of Certified Senior Advisors has a great list of questions to ask when choosing a home care provider. Click here to read the article.

Understanding what services are offered Home health care workers provide in-home medically necessary services, such as administering medicine, while home care workers provide in-home, non-medical services such as preparing meals, assisting with hygiene and housekeeping.  Either an agency or an independent provider can supply these kinds of services in a senior’s home.

A good assessment by the adult child or caregiver will help align appropriate services, and by not paying for aid that isn’t needed, this assessment can also help keep costs down.

Starting a conversation with a senior parent about home health care Before approaching a senior parent to discuss bringing in a home health care worker, put yourself in  that senior’s shoes. Think about what  that senior  is most frustrated about and be empathetic. Understanding the situation is extremely important in relating to the senior’s emotions, and timing is crucial in setting the stage. Choose a time when tensions are low and there is plenty of time for a discussion.

To make the conversation the most productive,  focus on the senior’s safety and helping them maintain independence. Concentrate on why and how an in-home health care worker can actually make life easier and safer.  The Society of Certified Senior Advisors has a comprehensive guide to creating a safe and functional home environment for your loved ones that includes recommendation for home safety changes for each room in the house, what equipment is covered by Medicare and tips for finding the right contractor. Click here to read it.

Jake Harwood, Ph.D., the former director of the University of Arizona’s Graduate Program in Gerontology and the author of Understanding Communication and Aging (2007, Sage Publications), offers tips to help family caregivers communicate with their aging parents on sensitive subjects.

  • Get started. Start observing the senior loved one and gather information carefully and thoughtfully. Don’t reach a conclusion from a single observation and decide unilaterally on the best solution. Base the conversation on multiple observations that are gathered with an open mind.
  • Talk it out. Approach the senior parent with a conversation. Discuss your observations and ask the senior for their opinion about what is going on. If the senior parent acknowledges the situation, ask for their opinion about what would be good solutions. If the senior parent doesn’t recognize a problem, use concrete examples to support the case.
  • Sooner is better. Talk sooner rather than later when a crisis has occurred. If the senior has poor eyesight or has trouble driving at night, begin to address those issues before a problem arises.
  • Maximize independence. Always try to move toward solutions that provide the maximum amount of independence for the older person. Look for answers that optimize strengths and compensate for problems. For instance, if your loved one needs assistance at home, look for tools that can help them maintain their strengths.

Recognize the senior’s right to make their own life choices, especially if a home care worker is coming to the house. The senior is likely to be more agreeable if their concerns or wishes are respected during the decision-making process. The sooner you begin conversations with an aging parent about how they can remain safe and maintain independence by using home care, the easier it will be to approach the topic over the long-term, before any major safety concerns are presented.

Source: Society of Certified Senior Advisors

How Do I Qualify For Home Health Care Coverage Under Medicare? To qualify for Medicare home health coverage, you must meet all four of the following conditions:

  • Your doctor must have determined that you need medical care in your home, and the doctor must prepare a plan for your care at home. Your doctor and home health agency personnel must review your plan at least every 60 days.
  • You must need at least one of the following: intermittent (not full-time) skilled nursing care, physical therapy, speech language pathology services or occupational therapy.
  • You must be homebound. Your home can be a house or apartment, a relative’s home or even a home for the aged, but a hospital or other facility that mainly provides skilled nursing or rehabilitation services does not qualify as a home. You may be considered homebound if you leave home only with considerable effort. Absences from home must be infrequent, or of short duration, to get medical care or to attend religious services.
  • Medicare must approve the home health agency caring for you.

Source: AARP.

Find out more information on Medicare and what is covered in the webinar from the Society of Certified Senior Advisors titled, More About Medicare and Changes in 2012. Click here to access this video.

New Technology Aims to Keeps Local Seniors Independent Longer

ANCHOR HomeSupport Partners with ClearCare to Bring

Aging-in-Place into Modern Age

Long Beach, CA – ANCHOR HomeSupport announced today that they are partnering with ClearCare to implement new technology that aims to help local community residents  live independently as long as possible. The comprehensive homecare system utilizes iPads/tablets, smartphones, and the latest software technology to connect professional home care providers with everyone else involved in a client’s care (including themselves and their family members).

“I’m in this business because I believe that people should have quality care, compassion, and companionship,” says Lara Davini, owner of ANCHOR HomeSupport. “That’s also the reason I decided to implement ClearCare’s technology.  Not only does it make our services more efficient and transparent, it allows us to keep families involved and informed in real time, which is a big priority for me.”

Using ClearCare, the ANCHOR HomeSupport team of trained caregivers can access their schedules, clock in and out, and report instantly on the status of the client’s care from the home, from a designated smart phone or tablet (such as an iPad), or from the client’s home phone. In addition, clients’ families can log in to the ClearCare portal to find out what is happening in the home in real-time.

ANCHOR HomeSupport says, “The ClearCare solution automates our back-office tasks, which means we will have more time to focus on bringing quality home care to more members of our community.”

For more information about ANCHOR HomeSupport, visit www.anchorhomesupport.com or contact one of our friendly Project Specialists at 562-395-3580.

ANCHOR HomeSupport

ClearCare is a San Francisco-based company that offers the world’s first front and back office solution for the home care industry.  

A difficult lesson in hiring a caregiver for mom

Caregiver eating with elderly woman

It’s All Relative.
July 09, 2011|By Rosemary McClure, Special to the Los Angeles Times

My friend’s phone call numbed me.

Twice in the last week, she said, she’d seen my mother sitting in a car in a neighborhood near her home. “Today she was there for more than two hours in the heat,” she added.

My stomach churned.

Mom suffered from dementia; she could no longer drive, or even speak coherently most of the time. She hadn’t gotten to the area my friend was talking about on her own.

Read moreA difficult lesson in hiring a caregiver for mom