ComForCare Home Care Serving Somerset & Northern Middlesex Countries

Archive for Home Care

Monday , November 14 , 2016

Matchmaker, Matchmaker

Much of what we do in home care business is administrative: arranging schedules, handling call offs, following hiring protocols, assessing clients and documenting, documenting, documenting. The data entry and paperwork is endless.

But at heart our business is all about human beings interacting with one another, so in the long run our success relies on pure people skills. Nowhere is this more important than in finding the right “match” between caregiver and client. It’s definitely an art, not a science.

The first consideration is ensuring that the home health aide has the right skill set, experience and strength for the client, but the rest is about finding the right personality match. A skilled home health aide who is beloved by multiple past clients may nevertheless rub her new client the wrong way and there may be no “fixing” the situation short of changing the aide.

A complicating factor is that many of our clients are convinced they don’t need our help in the first place. It’s their pushy children who are forcing them to do this, they tell us. (Never mind that they are 95, legally blind and recovering from a broken hip. By golly, they’ve always done everything on their own and they don’t see why that should change now!)

In these cases, just getting in the door is success. Being permitted to stay for the entire shift is a major victory. Clients who are resistant from the get-go usually won’t help our cause by saying just what they would like to have done. We know we’ll be more likely to succeed if we send a home health aide who is creative and proactive about setting their own schedule of things to accomplish on the shift. They need to prove their value to the client.

Other clients love nothing more than giving directions, right down to the last detail of how they want things done. They need someone who is willing and compliant. If the client’s manner is gruff or even hostile, we need to match them with an aide who is mature, experienced and self-confident enough to know not to take things personally.

Patience and understanding are all the more critical with clients who have dementia. Dementia patients can lose their social inhibitions and say things they never would have dreamed of saying in their pre-dementia lives. Family members are often mortified to hear what comes out of a parent’s mouth, but caring, experienced home health aides are usually unfazed by this behavior. They understand the situation. It’s very important for us train employees for dementia care and to recognize ahead of time who does not have the right temperament to succeed with these clients.

There’s no way around it: some customers are just plain difficult. And rude, demanding behavior is tougher to put up with when there is no dementia involved. In those cases we have to remember—and remind the home health aides involved—that even difficult people need care. Maybe there are extenuating circumstances such as pain or frustration at being dependent that we need to keep in mind.

Regardless, we do our best to help everyone who needs it. One of the clients we have been providing around-the-clock care for over 6 years has “fired” rejected over 35 people. One aide carried too large a handbag, she said. Another one was a “moron,” and yet another (one of our sweetest and most skilled) “looks like a man; don’t send her back.”

As you can imagine, we had almost as many employees who didn’t want to work with her either. “I need money but not that bad,” was a common refrain. We don’t force the home health aides to take a client they aren’t happy with. The “match” has to work both ways.

With effort and creativity we’ve managed to provide this client uninterrupted care all these years. We have a pretty finely tuned sense of who will pass muster with her by now. And we make sure to thank the home health aides effusively and frequently so they know they are deeply appreciated by us, even if the client herself takes their efforts for granted.

On the bright side, there are times when we get the perfect fit right away, and that makes us really happy. Over ten years ago I signed up a client who needed a companion several days a week. When I dropped by toward the end of the first shift to see how they were doing I found the two of them sitting on lawn chairs and chatting like the oldest of friends. All these years later they are still inseparable pals and the client, now in her 90’s, is still living in her home.

Posted in: Caregivers, Home Care

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Monday , May 16 , 2016

New Insights Into Home Care Industry

The Home Care Association of America just released a powerful report. “Caring for America’s Seniors: The Value of Home Care” is collection of data and insights about the growing home care industry. In addition to industry facts and statistics, the report includes stories from caregivers and families about the value of home care.
We encourage you to read the report and use this information with potential clients, caregivers and referral sources.

Download the full report HERE

Download the infographic HERE

Posted in: Home Care

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Sunday , July 5 , 2015

Talk to Me

There are many ways dementia can lead to social isolation, but one of the first is that verbal communication becomes challenging for dementia patients. Sadly, family and friends sometimes respond by talking to them less. This is a real shame because all of us, dementia patients included, have a deep need to communicate with others. Talking to and listening to other people is crucial for helping dementia patients maintain socialization, emotional connection and cognitive ability.

When we interact with dementia patients we need to understand that communication is still taking place, even if the conversation doesn’t go the way we would expect. Communication can exist, in fact, even if our conversational partner is repeating herself, not finding the right words or not making sense. The rhythm and pace of conversation, the tone of voice, the facial expressions and the response we make to the mood of the speaker are all very important. These things help us keep a human connection with the dementia patient and create opportunities for moments of clarity and understanding.

So much is lost if we stop making the effort to have conversations or (one of my big bugaboos) if we talk over the heads of the dementia patients to others in the room instead of including them in the conversation.

What’s more, if you’ve spent time with early- and mid-stage dementia patients you know that clear communication can come and go, almost as a camera can drift in and out of focus. If you aren’t able to understand what you are being told at the moment, just wait. You never know when a ray of wit, clarity or insight will flash through the mist and dazzle you.

A few years ago we were providing care for a married couple who lived close to my home. At first, we had a home health aide there for just a few hours a week. Over time, the care need expanded, and eventually we were with them around-the-clock.

These two were quite challenging to care for, but a total delight to know. The wife was wheel chair-bound due to a couple of falls, and she also had a little memory loss. The husband, on the other hand, was physically quite robust, but rapidly progressing into advanced Alzheimer’s.

The wife was Florence. She was kind and quietly friendly to everyone–a reserved and gentle person. Her husband Vince was small and slight in stature, but full of energy. He had an outsized, expansive personality, a huge toothy grin, and lots of great stories to share.

These two had many accomplishments in their long and collaborative marriage. Both had served in World War II. Florence in the Women’s Army Corps (WACs), and Vince in the army, where part of his duties had been to give navigational guidance to American pilots flying into Germany.

The walls of their small townhouse were hung with numerous paintings Vince had made after the war. They were scenes of small town neighborhoods and soft evening light. For decades he had managed a thriving photography business in Manhattan, but he was a painter by avocation and the walls of his home showed his skill.

Like many Alzheimer’s patients, Vince’s mind was quite sharply present at times. Other times his thoughts took some lengthy detours of time, person and place. Awareness came and went. With help in the home, most days he was managing quite well.

One day I got a panicked call from our home health aide, telling me that, while she was helping Florence in the bathroom, Vince had wandered out of the house. That’s when we realized we needed a lock high on the inside of the door.

But, in the meantime (Oy vey and Sacre bleu!) our gentleman was on the loose. The home health aide went in pursuit and, as I was nearby, I joined her in few minutes. We found him quickly and gave him a friendly escort home.

Vince wasn’t quite sure what had just happened, but he did have a sense that we had rendered him a service. So like the true Manhattan gentleman he was, he felt a tip was in order. He clutched his pants with his left hand and rummaged deep in his right pocket to find us a $10.00 bill, staggering and almost losing his balance in the process.

It took another five minutes to assure him that the service we had rendered was negligible…”our pleasure… no gratuity required, truly.” Then it was dinner time, and the day ended happily.

Another time I had driven the couple to a doctor’s appointment and, while Florence was being seen, I sat in the waiting room with Vince. To pass the time, I asked him about his service in World War II. Like many dementia patients, his long term memory was often quite sharp and he loved talking about this time in his life.

Remembering that his wife had also been in the military, I asked him, “So, Vince, when you were stationed in France, where was Florence?” His bushy eyebrows raised a bit and he replied slowly (as though to a slightly slow-witted school child), “In the middle of Italy.”

Nothing wrong with his geography.

Posted in: Aging, Dementia, Home Care

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