When Your Parents Need Help
As a loved one
In this Q&A article, three experts in the field of home health care answer some of the questions families may have.
“Ultimately our goal is for patients to be safe and for them to stay in their homes independently for as long as they can.”
Isshia Graggs, RN Director of Clinical Services
VNA Health at Home
16 years experience
“I like to have a family meeting where everybody gets all their questions answered. As we continue to proceed, it is helpful to work through one point of contact for the family.” — BECKY BEANBLOSSOM
Ask the Expert:
Becky Beanblossom, President
Home Instead Senior Care
What advice do you offer families when a loved one really doesn’t want outside help coming in, but the family members feel it is in everyone’s best interests?
BECKY: It is important to understand and identify why people feel the way they do. Encouraging open, honest conversations with those we love often allows us to gain understanding about their motivations, fears and needs. When we have a better understanding about such things, we are in a better place to come alongside our loved ones and help them navigate this stage of life. It can also be helpful to call in a third party to facilitate the conversation and touch on topics that may be uncomfortable for the family to address.
How should a family handle it if they bring in home health care, but it is not a good fit?
BECKY: We believe it is important that the person receiving care feels they are in control of the situation and are being heard. Seeking to understand why the care is not a good fit is important. It could be the client is not having their needs met and the plan of care needs to be modified. It could be the needs and desires of the client are not met by the current schedule or caregiver assigned. Having a conversation about what is working and what is not is the way to get to the bottom of the issue and quickly find a resolution. Our Nurse Case Managers find having regular visits with our clients allows us to talk through client goals, needs and expectations on a regular basis and stave off issues that could arise.
What specific types of home health care options are there for older loved ones?
BECKY: We are fortunate to have many care options available. The key is selecting the right care at the right time. I would advise reaching out to a professional that can help explain all of the options available. We meet with families often to help them determine which care options are best for their situation. I was taught early in my career that one should always try the least-restrictive environment first. I continue to stand by that philosophy today, and feel fortunate to be in a position to help those who choose to remain comfortable and independent, wherever they call home.
I think it is difficult to assume a family that has never walked this road before is going to immediately know what they need. That’s where we need to be the experts in our industry; we need to help them walk through our assessment process.
“Continuity of caregivers is so very important. That’s what makes clients feel good; they get to know that caregiver and the caregiver knows their home, their likes, their dislikes, and how they want things done.” — NANCY GALLOWAY
Ask the Expert:
Nancy Galloway, Owner
Senior Helpers-Louisville and Southern Indiana
How do you help families know if an older loved one needs home care?
NANCY: We have a new client assessment tool called Senior Helpers Life Profile that generates scores and helps us develop a care plan. This objective assessment measures a person’s level of risk across multiple areas, including safety, medical condition management, independence, and quality of life. It is based on 20 years of research, and we’re really excited about it. This tool will help us create our Smart Care Plan, which can accurately identify specific areas of concern that need immediate attention. We feel that it’s going to help us help families who know their loved one needs help but really don’t know how to address it or exactly what they need.
What is the benefit of getting a risk assessment even if a family decides not to proceed with home care?
NANCY: Using an assessment as a baseline can be beneficial. It identifies where their loved one is at risk. Our Life Profile risk assessment helps a family make changes internally or with outside help. In two or three months, you do another assessment and see how things have changed.
What types of care do Senior Helpers offer?
NANCY: We’re a licensed personal service agency specializing in Alzheimer’s and dementia needs, as well as Parkinson’s care. We offer companion care (cooking, cleaning, transportation, and med reminders) and personal care (bathing, incontinence, transfers). We have clients that we’re with once a week or month, and clients that we see 24/7. We’re very flexible.
What do you recommend families do if they are considering home care for a senior?
NANCY: If they can get to know an agency before they have a need, then they know who to call when there is a need. They should get a feel for who they trust. Have a clear vision of what type of care is needed, which is another reason to do our risk assessment.
Are families able to have a “trial run”?
NANCY: If a family decides to use us, they’re not signing a contract, and they’re not locked into any set timeframe. They can stop and start whenever they want. What we find is that once we get a good caregiver in, and we work very hard to match our caregivers to clients, the client and family usually end up being so happy to have the help, and they realize what it means to them successfully being able to live independently at home. We offer gift certificates to adult children who are trying to convince their parents to try home care, which is a way to see if they’re interested in it long term.
“When we admit a patient, we will customize our communication based on family needs. We keep a folder that has a calendar and a spot for vital signs. Sometimes families will leave a notebook.” — ISSHIA CRAGGS
Ask the Expert:
Isshia Craggs, RN, Director of Clinical Services
VNA Health at Home
What type of care does VNA Health at Home offer patients?
ISSHIA: We’re what is called intermittent acute care. Our main focus is medical need that is overseen by a physician. We receive our orders from a physician, but while we’re doing our care, if we see non-medical care needs, we help coordinate other resources.
Our big focus is post-hospitalization care, which makes up about half of our patients. It might be after surgery or worsening of a chronic disease, such as heart failure, COPD, or diabetes. Some patients have an infection and need 6-8 weeks of intravenous antibiotics at home. We’ll come in the home and teach a caregiver or the patient themselves. Some patients are struggling to manage their chronic diseases, and their physicians are trying to prevent them from going into the hospital.
Ultimately our goal is for patients to be safe and for them to stay in their homes independently for as long as they can.
What is the process of coordinating home medical care?
ISSHIA: Typically, the physician’s office liaison or hospital will contact us, but patients are able to call, and we will guide them through the process. We evaluate the patient to identify their needs, and then we collaborate with the doctor to come up with a plan of care. If we identify needs with home safety, falls, or dressing, we can bring in physical and occupational therapy. Our goal while in the home is to maximize our time to have the best outcomes.
What is the frequency of home health care for medical needs?
ISSHIA: As of right now, an episode is nine weeks (60 days). At the end of that time, we do a reassessment and may recertify the patient for another period of time. However, if we identify new needs that the patient has, it is our responsibility to bring those to the attention of the physician, and adjust frequency to patient’s needs.
What type of training is provided to caregivers to meet patients’ medical needs?
ISSHIA: It’s really surprising what we can train a family to do. There are some types of infusions that patients and caregivers are not taught, such as blood products and certain drugs that require a nurse to monitor. We make sure caregivers and patients are capable and safe, and there is always a nurse on call, 24 hours a day, so families always have a resource to reach out to.
How are patients monitored?
ISSHIA: We use telehealth monitoring in conjunction with visiting patients’ homes. We provide blood pressure cuffs, pulse oximeters, thermometers, and scales to patients free of charge in our telehealth program. Patients can log in through an app or call in their data. If we see anything out of the norm or patients don’t call in and check in with us, we’re going to call them.
Extra tidbit: Four tips for helping your parent(s) plan and execute a successful move.