Category Archives: Aging

When are Patients “Unsafe” for Home Care?

Reprinted by permission from Elisabeth Hogue, Esq.; (877) 871-4062; ElizabethHogue@ElizabethHogue.net

CaringForCaregivers-CGS-largeDischarge planners/case managers are likely to encounter instances in which home care, hospice, and home medical equipment (HME) providers state that they cannot accept patients because they are “unsafe” at home. The use of this term may be confusing to discharge planners/case managers. What is it about patients’ homes that make it unsafe for them to receive services there? Aren’t all patients appropriate for home care?

First, discharge planners/case managers may not have provided services in non-institutional settings. If so, it may be difficult to make a crucial distinction between institutional care and home health services. Specifically, in institutional settings the provider controls the “turf” on which care is rendered. In post-acute care at home, providers have little control over the environment in which services are provided. In fact, patients have almost absolute control over the “turf” in home care because services are rendered in their private residences.

Consequently, home care providers often confront barriers to the provision of services that many discharge planners have not experienced. Staff have, for example, encountered “attack geese” when they arrive at patients’ homes and risk the consequences of a serious pecking in order to reach patients’ bedsides! Or they have come eyeball-to-eyeball with a pet alligator, named Bubba, in a mobile home in Louisiana!

Although patients may not be adversely affected by pecking geese and may have a cozy relationship with Bubba, there may be other factors over which home care providers have no control that clearly jeopardize the well-being or safety of patients. These factors may make it impossible for providers to render services at home. Patients’ homes may, for example, be in such disrepair that both patients and caregivers are at risk. A home health nurse, for example, recently fell through the floor of a patient’s home as she approached the patient’s bedside. Patients’ homes may also be invested with roaches, rodents and/or vermin of various types and descriptions. Despite appropriate interventions from providers, patients may suffer repeated falls at home that make it risky or unsafe for them to remain there.

Despite these examples, discharge planners/case managers may still be unclear about why patients cannot be cared for at home when post-acute providers decline referrals on the basis that patients are “unsafe.” It may be helpful for providers to be more detailed in their communications. Specifically, providers could say, “The patient’s home environment will not support services at home for the following reasons….” When providers’ communications with discharge planners/case managers are vague, discharge planners might prompt clearer communication by asking: “What are the specific reasons why this patient’s home environment will not support home care services?”

Institutional care and home care services are fundamentally different models of care. Because the differences are so great, it is reasonable to expect that providers who practice primarily in institutions and those who work in home care may not always understand or account for important factors involved in different types of care. Clear, specific communication is, therefore, absolutely essential for the well-being of patients.

Well Beyond Care:

WellBeyondCare.com gives those who need care the tools to manage their in home care online. Careseekers, or family members looking for someone to help care for their parents or loved ones, can use the website to search for qualified nurses and caregivers, post jobs that outline their specific care needs, monitor their caregivers’ schedules, and make payment online and receive personal support, local support from their personal Nurse Care-Pair Manager. Caregivers can use the website to search for caregiving jobs, set their wages, post their weekly availability, receive weekly payment, and build their resume and portfolio with real experience. Join for free today at WellBeyondCare.com.

A Simple Pineapple

pineappleThe pineapple is a member of the bromeliad family. It is extremely rare that bromeliads produce edible fruit. The pineapple is the only available edible bromeliad today.

It is a multiple fruit. One pineapple is actually made up of dozens of individual floweret’s that grow together to form the entire fruit. Each scale on a pineapple is evidence of a separate flower. Pineapples stop ripening the minute they are picked. No special way of storing them will help ripen them further.

Color is relatively unimportant in determining ripeness. Choose your pineapple by smell. If it smells fresh, tropical and sweet, it will be a good fruit. The more scales on the pineapple, the sweeter and juicier the taste.

After you cut off the top, you can plant it. It should grow much like a sweet potato will.

This delicious fruit is not only sweet and tropical; it also offers many benefits to our health. Pineapple is a remarkable fruit.

We find it enjoyable because of its lush, sweet and exotic flavor, but it may also be one of the most healthful foods available today. If we take a more detailed look at it, we will find that pineapple is valuable for easing indigestion, arthritis or sinusitis.

The juice has an anthelmintic effect; it helps get rid of intestinal worms.

Let’s look at how pineapple affects other conditions.

Pineapple is high in manganese, a mineral that is critical to development of strong bones and connective tissue. A cup of fresh pineapple will give you nearly 75% of the recommended daily amount.

It is particularly helpful to older adults, whose bones tend to become brittle with age.

Bromelain, a proteolytic enzyme, is the key to pineapple’s value. Proteolytic means “breaks down protein”, which is why pineapple is known to be a digestive aid. It helps the body digest proteins more efficiently. Bromelain is also considered an effective anti-inflammatory.

Regular ingestion of at least one half cup of fresh pineapple daily is purported to relieve
painful joints common to osteoarthritis. It also produces mild pain relief.

In Germany, bromelain is approved as a post-injury medication because it is thought to reduce inflammation and swelling.

Orange juice is a popular liquid for those suffering from a cold because it is high in Vitamin C. Fresh pineapple is not only high in this vitamin, but because of the Bromelain, it has the ability to reduce mucous in the throat. If you have a cold with a productive cough, add pineapple to your diet. It is commonly used in Europe as a post-operative measure to cut mucous after certain sinus and throat operations.

Those individuals who eat fresh pineapple daily report fewer sinus problems related to allergies. In and of itself, pineapple has a very low risk for allergies. Pineapple is also known to discourage blood clot development. This makes it a valuable dietary addition for frequent fliers and others who may be at risk for blood clots.

An old folk remedy for morning sickness is fresh pineapple juice. It really works! Fresh juice and some nuts first thing in the morning often make a difference. It’s also good for a healthier mouth. The fresh juice discourages plaque growth.

Retirement Age: Caring for Baby Boomers

200258139-001To date, over 75 million baby boomers are dealing with the reality of having to care for their aging parents or grandparents. Supplying geriatric care needs can affect these individuals on many different levels. Impediments such as arthritis, high blood pressure or increased blood sugar levels are just a few of the concerns that may require the attention of someone taking care of an elderly person. In addition to these medical conditions, incontinence and immobility may be another burdening concern, as well as comorbidities such as COPD (Chronic Obstructive Pulmonary Disease, CHF (Congestive Heart Failure, and Dementia. With this in mind, aging adults may need the assistance of geriatric care professionals, in conjunction with skilled caregivers, in order to afford a safe, healthy, stress free environment for loved ones.

Today, a number of geriatric care options exist for concerned baby boomers to choose from. There are nursing homes, assisted living facilities (ALF), independent living facilities, and in-home care service providers. Depending on the extent of service and assistance necessary, any of these geriatric care options could be a viable solution. While nursing homes and assisted living facilities may be more convenient for the responsible family member, these sorts of geriatric care options may also be cost prohibitive. According to the Genworth Cost of Care study, nursing homes can cost up to $6,390 per month. Assisted living facilities usually charge less, while in-home care is the least expensive option with flexible payment rates that can vary depending on the skill set and time required for the patient’s care.

Aside from these usual geriatric care options, there are those who choose to offer care for their elderly parents or grandparents personally. They are called “informal caregivers”, as they provide in-home care for their parents or grandparents without formal training or education in geriatric care. While this setup may be motivated by very noble causes, the physical, emotional, and psychological pressures associated with this kind of arrangement could become a very large burden for someone to assume. In addition to the pressure of caring for an elderly person, there may also be some legal implications if you cannot provide the level of appropriate geriatric care needed for your elderly relatives.

Just recently, prosecutors from the State of Pennsylvania charged an “informal caregiver” with allegedly committing “assisted suicide” to his chronically ill and aged father, in spite of the personal requests to end his life due to the fact the father felt an undue burden was being placed on his child. It is important to note that taking care of the elderly requires tremendous amounts of dedication, care, and caution on a daily and ongoing basis.

Considering the challenges and dilemmas baby boomers face regularly while fulfilling their obligations to provide geriatric care for their elderly parents or grandparents, they may still require the assistance of a geriatric care professional and a private duty caregiver, in one form or another.

Well Beyond Care:

WellBeyondCare.com gives those who need care the tools to manage their in home care online. Careseekers, or family members looking for someone to help care for their parents or loved ones, can use the website to search for qualified nurses and caregivers, post jobs that outline their specific care needs, monitor their caregivers’ schedules, and make payment online and receive personal support, local support from their personal Nurse Care-Pair Manager. Caregivers can use the website to search for caregiving jobs, set their wages, post their weekly availability, receive weekly payment, and build their resume and portfolio with real experience. Join for free today at WellBeyondCare.com.