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Is In-home Care the Better Choice Post Covid-19?

Tuesday , September 15 , 2020

Is In-home Care the Better Choice Post Covid-19?

According to the California Healthcare Foundation, more than 40% of Covid-19 fatalities so far were nursing home residents or workers. And that number is true across the nation – not just in the Golden State.

Shocked? You shouldn’t be. Despite strict regulations, nursing homes have long struggled with infection control.

The same organization states that “nursing homes are hot spots because they combine numerous risk factors for transmission: congregate living, a mostly elderly population with underlying health conditions, and inadequate staffing, PPE, and infection control for an emergency.”

And the public has taken notice. Healthcare consulting firm Transcend Strategy Group recently surveyed 1,000 family healthcare decision-makers across the country and found that two-thirds of respondents say they plan to use in-home care rather than facility-based care in the future.

Among those surveyed, 65% said Covid-19 has changed their opinions about how to best care for older adults, while 68% said they don’t believe that quality care can be provided in congregate settings.

We’ve put together a brief overview of in-home care, so you can make your own decision. Keep reading to learn more:

Aging in Place 

Maya Angelou said, “The ache for home lives in all of us, the safe place where we can go as we are and not be questioned.”

There is no time this is truer, perhaps, than as we enter old age. According to the AARP, three out of four adults say they want to age in place, even if they need help with day-to-day activities.

Many seniors fear dying alone in a nursing home, surrounded by people they don’t know. When the time comes, they’d prefer to be at home, in an environment that feels safe and in the company of those they love.

The Benefits of In-Home Care 

Home care can provide a variety of benefits for older adults who choose to age in place. Among the most important advantages is assistance with activities of daily living, including help with cooking, cleaning, and even bathing. Here are some other pluses you may be unaware of:

  • It may seem obvious, but in-home care allows seniors the opportunity to age in place among their friends, family, and those they care about most. This can directly contribute to better mental and physical health as they age.
  • Older adults who age in place feel a greater sense of freedom and the independence to live life on their own terms.
  • In-home care providers can perform a wide variety of services, from help with daily activities to round-the-clock care.
  • Home care professionals can provide family caregivers with peace of mind that their loved one is safe and secure while they go to work or tend to other duties.
  • Older adults who have had surgery or have been hospitalized for an illness face a lesser risk of falls when recovering at home. Home care can also reduce the risk of hospital readmission.
  • If your older loved one has specific medical needs, in-home nurses can provide skilled treatment, including wound care, intravenous infusions, and tracheostomy management.
  • With in-home care and the rise of wearable technology, older adults can now receive continuous monitoring from the comfort of their own homes.
  • Much more.

Of course, there are cases where an assisted living facility is the only option – and there are pros and cons to both in-home care and living in a nursing home. One of the biggest considerations should be the health needs of your older loved one. Remember to involve them in the decision-making process and do your research.

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Caring For A Loved One After Joint Replacement Surgery

Monday , November 4 , 2019

Caring For A Loved One After Joint Replacement Surgery

Joint replacement may seem like an “old person” surgery, but creaky knees know no age! In fact, I can distinctly remember my father having both knees replaced when he was only in his early 40s. And a friend of mine – just 37 years old – recently had both hips replaced.

There are a variety of reasons adults (both young and old) might need joint replacement surgery. For my dad, it was a career in the military and years of physically demanding work that destroyed his knees. And my friend’s hips were ruined after several rounds of cancer-killing radiation were directed at her pelvis.

No matter how old your loved one is when they have a joint replaced, they will need a helping hand to assist them through the various phases of surgery – both before and after. If you’re about to step into the role, understand that it can be a time-consuming and demanding task (but also incredibly rewarding).

Here are some of the ways you can help make the process a little easier:

 

Preparing Your Home For Recovery 

Every joint replacement patient has different needs, and the restrictions they face after surgery will depend on several factors. Still, many people find it helpful to set up a “recovery room” on the first floor of the house. This room should include:

  • Easy access to a nearby bathroom OR a bedside urinal/commode (Note: It may be necessary to install grab bars in the bathroom)
  • A bed that isn’t too high off the ground
  • A telephone or cellphone (with charger) to call for help
  • Bandages and other supplies necessary for wound care
  • A walker or crutches, if needed
  • Open walkways, without rugs or electrical cords in the way
  • Comfortable clothing and shoes that are safe for walking around the house
  • A variety of snacks and beverages
  • Several entertainment options (books, crosswords, television, etc.)

Recovery

During the recovery phase, your loved one may need significant assistance in their activities of daily living.

  • Medication: Depending on the type of surgery, it is not unlikely that one of more medications will be required. Ask the doctor if she can provide the prescriptions in advance, so you can have them ready and waiting at home prior to surgery.
  • Meals and snacks: If you will not be living in your loved one’s home full-time, it is vital that they meals they can quickly and easily make on their own. Try preparing a few options in advance that can be quickly reheated in the microwave – or provide quick meals that don’t have to be heated at all.
  • Wound care: Your loved one will likely have bandages and dressings that need to be changed daily (or more). If possible, meet with your loved one’s doctor in advance to learn proper techniques and safety procedures before outpatient care begins. 
  • Household tasks: Depending on the type of joint replacement your loved one receives (knees, hips, etc.), they may not be able to stand or bend for a period of several weeks. This typically means that most household chores are out of the question. Plan to take on these tasks on your own or arrange for outside help. 
  • Doctors appointments: Post-surgery, your loved on will likely have several follow-up appointments within the first four – six weeks. Missing an appointment can leads to setbacks and complications, so it’s vital to take these follow-ups seriously. 
  • Activity: Exercising can have a big impact on a patient’s recovery. Your loved one’s doctor will likely prescribe a home exercise program in addition to outpatient rehab. Help them chart their efforts and results, and provide the motivation to stay on track.
  • Paperwork: As with any surgery, joint replacement comes with a lot of paperwork. On top of the discharge orders provided by the hospital, your loved one will likely receive reports at each follow-up visit – and an absolute flurry of bills in the mail. Help them stay on top of things by organizing everything in an accordion folder or binder with tabs for each type of correspondence.

Self-Care

Remember during this difficult time that it is also important to take care of YOU. It’s easy for caregivers to fall into the trap of constantly providing and never receiving – and that is a quick road to burnout. Remember to:

  • Take breaks
  • Eat a healthy diet
  • Make time for exercise
  • Maintain outside interests
  • Stay in touch with family and friends
  • Get enough sleep

If you’re feeling overwhelmed, this is not the time to grin and bear it. Your lack of wellness won’t only affect you, it will also affect the quality of care you can provide to your loved one. Don’t be afraid to reach out and ask for help if you need it!

Final Thoughts

Proper preparation can help you provide the best care possible for your loved one after their joint-replacement surgery. Recovery can be difficult, but it will be a lot easier with you helping out!

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New Jersey Home Care Standards & Accreditation Explained

Monday , September 23 , 2019

New Jersey Home Care Standards & Accreditation Explained

As a licensed agency providing care for seniors and the disabled in their homes, my agency has a lot of “masters.” Foremost among them are our clients. We respond to their needs in all that we do, and we answer to them for the quality of our services. That much is straightforward.

What is less obvious to most people is that we also answer to the NJ Division of Consumer Affairs (who grants us our license), the NJ Board of Nursing (who writes detailed best practices governing our standards and day-to-day practices), and an accrediting agency approved by the state to inspect and review every aspect of our business.

As of 2019, accreditation is now a requirement for any home care agency in the state, and the Division of Consumer Affairs has committed to shutting down those agencies who don’t comply.

Certification in New Jersey

New Jersey has some of the most stringent regulations in the nation governing the provision of care services to seniors in their homes.

On March 18, 2019, Governor Murphy signed and enacted Senate Bill Number 2773, which clarifies the definitions of Health Care Service Firms and Homemaker/Home Health Aides. The bill ensures that “all firms acting as health care agencies for our elderly, including the ones using the Internet to arrange and provide companies or health care services, are properly registered.”

While most other states do not require that an employee who provides personal care be certified or show proof of any training. In New Jersey, any aide who touches a client, whether it is to help them into a wheelchair or to give them a sponge bath, must be “certified.”

To receive certification, the aide must successfully complete a training course approved by the Board of Nursing. Once they have passed, they may call themselves a CHHA (a Certified Homemaker Home Health Aide.)

And that’s only the first step!

CHHAs must renew their licenses every two years, and the state will not grant that renewal unless the aide can prove that he or she is working under the supervision of a registered nurse. In other words, they must work for a licensed agency like ComForCare who employs RNs to assess patients, write detailed care plans, and supervise the home care aides.

Home Care Best Practices – It’s the Law!

Clients are sometimes surprised (and sometimes annoyed!) at how in-depth our initial assessments and bi-monthly reassessments are. It generally takes our nurses at least two hours in the home every 60 days to review and document according to state regulations and our accreditation standards. This thoroughness can seem excessive to clients, but the NJ best practices were written to safeguard the health and safety of home care clients.

Our nurses can (and do) catch problems that doctors and families are unaware of—everything from flagging fall risks in the home to addressing the potential for skin breakdown that can lead to life-threatening pressure ulcers. They connect clients who have balance and strength problems to physical therapy, catch medication errors such as duplicate prescriptions under different medication names, and flag cognitive decline that would indicate a need for more safety supervision.

In addition, the RNs are regularly supervising and evaluating our HHAs to make sure they adhere to nursing standards and understand what is required under the patient’s plan of care.

Final Thoughts

Over the past couple of decades, the home care industry was wide open to just about anyone who wanted to set up shop. Some agencies followed best practices in hiring and supervising aides, but others simply operated as “matchmakers,” much as current online registries operate.

When it comes to providing care for vulnerable seniors in private homes, choosing an accredited agency is the safest way of ensuring quality of care and accountability.

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