Category Archives: Safety

Signs Your Loved One Needs Care

As individuals age, many of the things they used to do with ease sometimes become much more difficult to do.  Acknowledging the need for help and then accepting assistance is not easy for individuals as they get older. Often, the decision and responsibility falls on one or Aging Mothermore family members to recognize the signs that your loved one might need support and aide in completing the activities of daily living. Many of these include simple tasks such as bathing, dressing, and cooking.

So, how do you know if it is time for in-home care for your loved one? There are some obvious signs that could signal a red flag that are listed below.  One may not be enough, but when these come in combination you should seriously look to have a caregiver aide in the home.

Reduction in Physical Abilities and/or Mental Status

  • Difficulty keeping track of time / forgetting appointments
  • Sleeping for most of the day / not waking properly
  • Poor diet or weight loss
  • Rapid weight gain
  • Loss of interest in hobbies, activities or in socializing
  • Uncertainty and confusion when performing once-familiar tasks
  • Changes in mood or extreme mood swings
  • Difficulty getting up from a seated position
  • Difficulty with walking, balance and mobility
  • Unexplained bruising or injuries from falls or hitting furniture
  • Forgetfulness, including forgetting to take medications or taking incorrect dosages
  • Consistent use of poor judgment (e.g. falling for scams or sales pitches, giving away money)

Deterioration in Personal Hygiene

  • Unpleasant body odor due to infrequent showering or bathing
  • A strong smell of urine in the house or on clothing
  • Noticeable decline in grooming habits and personal care (e.g. unkempt hair, untrimmed nails, lack of oral care, wearing dirty or stained clothing)

Neglecting Household Responsibilities and Upkeep

  • Inability to independently complete Instrumental Activities of Daily Living (ADLs)
  • Little or no fresh, healthy food in the fridge
  • Unkept, uncleaned house and/or extreme clutter
  • Unwashed laundry piling up
  • Stains or wet spots on furniture or carpet
  • Spoiled or outdated food that does not get thrown away
  • Stacks of unopened mail or an overflowing mailbox
  • Late payment notices, bounced checks and calls from bill collectors
  • Utilities being turned off due to missed payments

Hiring a Caregiver or Caregiving Service
If many of these indicators are present, it does not mean you have to place mom or dad into an assisted living or a nursing home facility. These are often very expensive and may not be the right choice.  However, these red flags do indicate that some form of daily supportive care is needed. You may have to consider hiring a private duty care agency, or as a much more affordable alternative, hire your own caregiver using a service such as Well Beyond Care.

About Well Beyond Care
Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover through the web application, WellBeyondCare.com.  The Company’s platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. Their solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.

Private Duty Services for All!

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

In order to be appropriate for home care services of all types, patients must be able to care for themselves or have primary caregivers who can meet patients’ needs in between visits from professional staff from home care providers. This requirement is necessary in order to meet the eligibility of many payors, to avoid risk of legal liability and to help ensure quality of care.

Patients’ family members or others may be willing to serve as primary caregivers on a voluntary basis. If not, providers should offer patients and/or their family members the option to pay privately for primary caregivers. These services may be referred to as private duty or non-medical services.

The option to pay for private duty home care services should be offered to all patients who cannot care for themselves and who have no voluntary primary caregivers. Patients who can care for themselves or have voluntary primary caregivers may also wish to contract for additional assistance, so providers should offer this option to all patients who may benefit from these services.

Specifically, this means that:

  • Hospital discharge planners/case managers should offer private duty services to all patients who may benefit from them and assist patients to arrange for such services post-discharge as part of the discharge planning process.
  • Other types of institutional providers; such as skilled nursing facilities (SNFs), Long Term Acute Care Hospitals (LTACHs), and independent rehabilitation facilities (IRFs); should also offer patients who are being discharged the option to arrange for assistance from private duty agencies and should arrange for such services post-discharge.
  • Assisted living facilities (ALFs) should offer private duty services to all of their patients who may benefit from such services.
  • Home health agencies should offer patients the option to private pay for services if primary caregivers are no longer available to provide assistance and if patients no longer meet the eligibility requirements of payor sources.
  • Home health agencies, hospices and home medical equipment (HME) companies should educate patients about private duty services even though patients may have voluntary caregivers and help patients and their families arrange for these services.

Providers may be reluctant to offer these services to patients and their families because of their cost. They may also erroneously conclude that patients and their families cannot afford them. Providers should not jump to conclusions about who can afford these services. Instead, private duty home care services should be offered to all patients and their family members who may benefit from them.

A home health agency, for example, decided that a patient no longer met the eligibility requirements of the Medicare Program. The staff of the agency was reluctant to offer the patient the option to private pay for additional services prior to discharge because the patient lived in a “shack” and drove an old, beat-up truck. They did so anyway. To the staff’s surprise, upon receipt of the offer, the patient got out of bed, extracted a wad of cash from under the mattress and told the staff that there was plenty more money to pay for private duty services!

Private duty care has a very important role to play in the provision of home care services. This type of care should be offered to all patients whenever it seems that patients may benefit from it.

About Well Beyond Care
Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover through the web application, WellBeyondCare.com.  The Company’s platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. Their solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.

 

Hospital Discharge Planners and Recommendations of Post-Acute Providers

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

MedPAC advises Congress about Medicare. The Remington Report in the October 4, 2017, edition of FutureFocus reported that a MedPAC staff member stated as follows at MedPAC’s September, 2017, meeting:

“The Balanced Budget Act (BBA) requires hospitals to provide beneficiaries with a list of nearby SNFs and home health agencies but the list is not required to have quality information….Medicare statute provides beneficiaries with the freedom to choose their PAC provider, the law states that hospitals may not recommend providers (emphasis added).”

Then in the March 7, 2018, edition of FutureForcus, a link was provided to a power point presentation presented by MedPAC on March 1, 2018. A slide entitled “Discharge planning is a hospital responsibility” that was included in the presentation states as follows:

“…Hospital discharge planners may not recommend specific providers-beneficiaries have freedom to choose PAC providers.”

Is it true that hospital discharge planners are prohibited from recommending post-acute providers to patients based on applicable federal requirements? The answer is a resounding NO!

The basis for the remarks of members of the staff at MedPAC seems to be Conditions of Participation (CoPs) of the Medicare Program that establish requirements for hospital discharge planning. Specifically, 42 CFR 482.43(7) says that hospitals must not specify or otherwise limit the qualified providers that are available to patients.

But making recommendations to patients about post-acute providers while emphasizing patients’ right to choose providers does not necessarily entail “specifying” or “otherwise limiting” the providers available to patients. In fact, such discussions seem to be required by applicable national standards of care the Case Management Society of America and sanctioned by the Centers for Medicare and Medicaid Services (CMS). Prohibiting these types of discussions also has practical implications for patients and their families.

Specifically, the Case Management Society of America (CMSA) first published Standards governing the practice of case management, including hospital discharge planners/case managers, in 1995. The Standards were revised in 2002, 2010 and 2016. Among other requirements, these standards require case managers to advocate on behalf of patients, including provision of assistance with making decisions about their care.

In addition, CMS sanctioned making recommendations to patients through the use of preferred providers. In final regulations of the Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services at 80 Fed. Reg. 73274 (November 24, 2015), CMS says on Page 73518: “We agree that hospitals should be allowed to identify preferred providers and suppliers…”

CMS goes on to say on Page 73520 that:

“…hospitals, if desired, may recommend “preferred providers,” that is, high quality PAC providers/suppliers with whom they have relationships (either financial and/or clinical) for the purposes of improving quality, efficiency, or continuity of care.”

Finally, anecdotally, hospital discharge planners/case managers often report that patients are unable to choose post-acute providers when lists are presented to them. In light of MedPAC’s comments above, it sounds like discharge planners/case managers are unable to provide assistance to patients except perhaps to hand them the equivalent of a copy of the yellow pages! From a practical point of view, this dog will not hunt! In fact, the “heart” of the discharge planning process includes recommendations from discharge planners/case managers about the best choices for patients. Patients are, of course, free to reject these recommendations.

Case management/discharge planning activities are at the heart of our healthcare delivery system. These crucial activities are finally receiving the recognition and “due” that they deserve. They should not be mischaracterized!

About Well Beyond Care
Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover through the web application, WellBeyondCare.com.  The Company’s platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. Their solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.

 

Common Diseases Seniors Face and Challenges in Providing Healthcare Solutions

Due to aging, diet, and living styles, seniors are more prone to degenerative diseases. As people age they become more susceptible to diseases and conditions that make even simple tasks difficult. Routine activities like grocery shopping, preparing meals and running errands become harder as we get older and adopt a sedentary lifestyle, which is why many elderly people seek assistance from caregivers. Though aging is a reality of life, it is important to know which specific diseases are most common among seniors in order to decide a course of action of prevention, and barring that, then which type of care or assistance is best for your needs.

According to a recent article in the New York Times, the most common diseases among seniors in the U.S. are Alzheimer’s or any other form of dementia, high blood pressure, heart disease, depression, diabetes, and chronic obstructive pulmonary disease (COPD). Each of these illnesses can have dramatic effects on the quality of life of seniors and their families. Caring for an aging parent with dementia or depression can be especially trying. And while there are some precautions one can take to avoid such diseases, like leading a healthy lifestyle, the inevitable deterioration associated with old age is the leading factor that make seniors vulnerable (Medicinenet, 2013).

Though these conditions may manifest alone as a single disease, the problem gets worse as these conditions overlap. According to recent studies, having one of these diseases may make an elderly patient more susceptible to contracting others. Dr. P. Murali Doraiswamy, a psychiatry professor at Duke University, suggests that there is a link between dementia and vascular diseases. Studies aimed at establishing these connections are currently under way. As these ailments and conditions coexist, seniors suffer more and start to need more care. These overlapping health conditions also call for more specialized care for the senior; they need a caregiver or nurse who has experience working with patients suffering from similar comorbidities.

To date, more than 733,000 Americans live in assisted living facilities (ALFs) (New York Times, 2013). These popular living arraignments for seniors and people with disabilities offer an easy solution for their families if they can afford it. Depending on the preferred facility, level of care required, and professionals called for to provide care, yearly rates may vary, but the cost of living in a nursing home or assisted living facility has increased consistently for the past five years and typically costs about $80,000 annually. With such high costs, many families are looking for more affordable alternatives without sacrificing the quality of care and stability for their loved ones.

Many healthcare professionals, including Registered Nurses (RNs) and Licensed Vocational Nurses (LVNs), are moving away from the old model of finding jobs in an established geriatric living facility. Uncertainty about the future of the healthcare industry has driven many qualified medical professionals to operate independently, working for private pay and visiting the patients in their homes. This limits the cost of care and allows aging loved ones to remain in their own homes.

The number of seniors who need personal care is ever increasing in the US. These individuals and their families have enough stress in their lives dealing with illnesses and deteriorating health, that the addition of navigating the waters of elderly care is simply too difficult to take on alone. Fortunately there are many resources available today that can help seniors and their loved ones find the care they need at a cost they can afford.

Well Beyond Care gives caregivers and those who need care the tools to manage their in-home care online. Caregivers, registered nurses, certified nurse assistants, and geriatric care managers can use the website to be best matched with Careseekers looking for care, set their wages, post their weekly availability, receive weekly payment, and build their resume and portfolio with real experience. Careseekers and family members looking for someone to give care for their parents or loved ones, can use the website to search for qualified nurses, CNAs and caregivers, are matched with a caregiver who can best can deliver care to specific care needs, monitor their caregivers’ schedules and payment online and receive personal support from the nurse that is assigned to them when they join. Join for free today at WellBeyondCare.com.

Fear of Falling? Here is an Alternative

As people age, their ability to fall diminishes and as a result, may falls end in hospital stays, or even worse, fatality. Here is an innovated approach used by the Dutch in this New York Times’ Article.

Just as in the Netherlands, there has been an increase in the number of elderly in the US, so too is there an increase in the number of deaths caused by falls.  Experts indicate that this increase is due in part to people living longer, the types of medications uses, and a general lack of activity.   This would be a great program to be imported to the United States as well.

Tips for Caregivers: Caring for Elderly Parents with Alzheimer’s Disease

Caring for patients with Alzheimer’s Disease (AD), resulting in dementia, can be a demanding experience due to their changing behavior. Every day brings new challenges and difficulties. A caregiver should have an effective plan in place to help them care for elderly patients suffering from Alzheimer’s.

Handling a person with dementia caused by onset Alzheimer’s disease or finding out that a loved one has Alzheimer’s disease can be stressful, challenging and frightening. Alzheimer disease is a progressive neurological disorder, affecting long and short-term memory, thinking skills, and human behavior. AD patients will forget how to perform basic daily tasks, but they also forget familiar people and places. Caring for a person with AD can become frustrating at times, but it is also extremely important because Alzheimer’s patients cannot usually care for themselves. Because our aging loved ones typically have such a hard time recognizing their surroundings, especially new ones, it is often recommended that patients stay living at home as long as possible rather than moving to a nursing home or assisted living facility.

Benefits of hiring your own Caregiver for elderly patients with Alzheimer’s

The benefit of hiring a caregiver directly is that you can select the person you like the best, has the appropriate dementia training, and who is the best fit for your family. Hiring someone directly is usually cheaper than hiring through an agency, and it is typically orders of magnitude less expensive than placing them in a nursing home.

The Internet makes it very easy to find an appropriately skilled caregiver near you. Using a fully integrated online service to hire a caregiver for your loved one is a new way to be matched with the best skilled caregivers, who are reliable, have a well-matched temperament, are verified, and affordable. Well Beyond Care makes hiring a caregiver simple and easy, allowing you to maintain control of your care needs or the care needs of a loved one.

Alzheimer’s Geriatric Patient Caregiver Tips

  • As a caregiver, it is vital to learn as much as possible about Alzheimer’s disease and what to expect from an elderly patient with Alzheimer’s, including taking as much training on AD and dementia as is available.
  • When possible, caregivers should learn about the elderly patient’s history and family. Surrounding the patient with items that remind them of their past or photographs or their loved ones may be beneficial to the patient.
  • A caregiver should not feel guilty if the patient is upset or confused. Always keep in mind that many behaviors associated with patient are due to the disease. Try to focus on their positive moments and good memories. Keeping a positive attitude will make helping the patient work through difficult times easier.
  • Engage the patient with games and books. Place more focus on having fun with the games rather than the patient’s illness. Entertain patients with interesting books to promote active listening.
  • Choose lively TV shows with simple story backgrounds to keep the patient occupied.
  • Play familiar music that the dementia patience likes to listen to. It has been shown that music is one of that memory functions to deteriorate with dementia.

About Well Beyond Care:

Well Beyond Care provides the tools that help you plan care and allow your loved ones to safely age in place.  It is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover.  Our platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. This solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.   Its online system combines the best in Caregiver matching (searching, screening, ratings & hiring) with all the back-office functions (time worked, payroll, scheduling, and notifications) to ensure safe, reliable, dependable, affordable care is obtained. It is the only company that gives each Careseeker access to their own local, personal nurse to help guide them through the hiring process. The Careseeker’s nurse provides advice on healthcare options and aids with transitional care.

How Can I find the Best Caregiver for my Parents?

More than ever, we live in a long-distance society and finding the best caregiver for your parents requires a lot of consideration. To begin with, being far away and entrusting your aging parents in the hands of others may be a tough decision, but knowing that they are in the good hands of a trusted and qualified caregiver can lower stress, give you and your parents piece of mind, keep them out of the hospital, and actually prolong the length and quality of life for them.

Before making any decisions, it is important to know your options in choosing the best caregiving means for your parents. There are a number of live-in facilities offering caregiving, and it’s up to you to decide which option best suits your parent’s individual caregiving needs. It is vital that you get to know each healthcare facility and what they have to offer, which will allow you to decide whether or not you are making all the right decisions for your folks. It is advisable at this juncture to try and locate a healthcare professional who knows the good versus poor facilities in your area.  You might be shocked at the exorbitant cost of housing your parents in a healthcare facility, and may decide that hiring a in home private caregiver is actually the best option.

In-Home Care: An Excellent Health Care Option

In most cases, having to leave one’s home to move into a nursing home or assisted living facility gives elderly patients unnecessary anxiety and stress. Alternatively, hiring an in-home caregiver to come take care of your parent in their home where they are comfortable and familiar alleviates this stress. They can get the same health care and assistance they require from the comfort of their home through personalized home health care services.

There are a number of different levels of home caregiving at a varying range of pricing that you can choose from, depending on the particular needs of your parents. You can employ a geriatric care manager to help you determine which level of care or qualification your parents might need. Qualification levels include Registered Nurses (RN), Licensed Vocational Nurses (LVN), Skilled Caregivers, and Companions or Homemakers. Their qualifications and expertise may vary, but these professionals and skilled health care workers provide assistance to their elderly home care clients in their clients’ own homes.

The responsibilities that these home health care professionals provide range from assisting their elderly clients undertake their daily tasks of living, such as taking a bath, using the toilet and administering medicine, to other routine activities that aging patients may need help with, such as going to a doctor appointment, grocery shopping and doing laundry.

What You Need to Know About a Home Care Provider

As soon as you have decided to hire a home health caregiver for your parents, the next thing you need to do is decide which duties that caregiver will need to perform to effectively care for your parents. For instance, you may address the following points concerning your caregiver of choice:

  • Skills or qualifications
  • Recommendations from past patients or clients
  • Number of years experience in caregiving
  • Accreditations and licenses
  • Confidentiality and client privacy policies
  • Records of inspections, ratings, and client satisfaction
  • Criminal background check

Apart from these concerns, you should also consider your budget. Hiring an in-home caregiver is typically much more affordable than nursing home or assisted living facility care. But more importantly, it is all about looking for a caregiver that offers the service that your parents require, at a rate you can afford.

Hiring an individual skilled caregiver is an excellent way to save money while building a close personal relationship with a high quality care professional.  But in saving money, make sure you are NOT endangering your parents by hiring an unscreened or unqualified caregiver.

Well Beyond Care gives both caregivers and those who need care the tools to manage their in-home care online. Caregivers, registered nurses and geriatric care managers can use the website to be matched with Careseekers and their family members who are looking for care, set their wages and weekly schedule, receive weekly payment, and build their resume and portfolio with real experience. Careseekers, or family members looking for someone to help care for their parents or loved ones, can use the website to be matched with caregivers who best match their specific care needs, monitor their caregivers’ schedules, and make payment online and receive personal, local support from a local Nurse Care-Pair Manager. These Nurse Care-Pair Managers offer assistance in understanding what is available with care in your community as well as helping you navigate any issues you might run into using the Well Beyond Care website. Join for free today at WellBeyondCare.com.

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.