Home care companies often “bond” their employees as a means of covering themselves in case a client reports an instance of caregiver theft. Bonding functions as insurance for the company and provides peace of mind for you. This is not a foolproof method of protecting consumers, but it does serve as an indicator of a company’s commitment to its clients. Ask if the company has bonded its employees (e.g. companions, certified nursing assistants, home health aides, nurses) and the value at which they are bonded. Insurance Every business should have insurance coverage in place. Request a copy of the company’s “insurance declaration page” as proof of coverage. Think about it: If a roofing company comes out to fix your roof, you’re going to want to see their proof of insurance. It is not out of line to ask the same of the company that will be caring for your loved one. Inquire About Certification and Accreditation There are various certifications and accreditations that home care agencies and their individual employees can voluntarily pursue. Any agency that has gone through the process of accreditation demonstrates a strong commitment to high quality care. Ask what certifications and/or accreditations the company and its caregivers hold and who provided them. Request Information on Caregiver Hiring and Training Procedures Home care agencies should establish education and credential requirements for their professional caregivers and conduct background checks and drug screenings as part of the hiring process. Caregiver Training and Education In most states, there are no education or training requirements for providing nonmedical services, such as companionship, light housekeeping, and transportation for appointments and errands. When personal care services are added to a caregiver’s responsibilities, they must typically receive some amount of training. Federal home health aide (HHA) standards require a minimum of 75 total classroom and clinical training hours. Some states choose to exceed this minimum training requirement in their examination and certification processes. Determine what in-house training is provided to the different levels of caregivers within the company and how their proficiency is assessed. Ask who provides the training. Find out if your state requires a specific amount of ongoing education and/or workshops each year. Ask the provider what they require on an ongoing basis as the mandatory minimum to keep their employees’ skills sharp. Background Checks Each state sets its own rules for running background checks on health care workers like certified nursing assistants (CNAs) and HHAs. Even in states that do not mandate background checks, many companies will conduct their own statewide or nationwide checks before hiring. Home care companies may also contact their state’s registry to verify the prospective employee’s licensing/certification status and check for existing hospital electric beds complaints. Ask the company how they vet employees. Are all employees subject to the same standards? (For example, are office staff members also required to pass a background check?) Determine if the company runs a nationwide criminal search, countywide search, drug screening, and/or credit check for new employees. Find out how often drug screening and criminal searches are repeated on existing employees. Ask About Care Management Procedures Learn the details of the process the home care company uses to get acquainted with a new client, assign caregivers, begin services and manage their ongoing care. Care Planning A care plan is an organized, customizable schedule of services for a client that the company can regulate and family members can follow along with. In states that require home care companies to obtain licenses, care plan development is mandatory for every client. Ask if the agency creates plans of care, how frequently they are reviewed and updated, and if they conduct regular quality assurance checks. Be prepared to answer leading questions about the care recipient’s health conditions and daily challenges and needs. This will allow a care coordinator to determine which services would be a good fit and how often they will be needed to improve and maintain the recipient’s quality of life. It is crucial for you to provide as much information as possible and refrain from holding back any details. Any problems with or alterations to an existing care plan should always be directed to a manager, such as a care coordinator, the head of staffing, or, in the case of smaller home care agencies, the owner. Ask how the provider handles changes in health and the level of care needed. Be aware that care plans may vary. Similar to gathering estimates on how to fix a roof leak, one contractor might tell you to patch it, while another will tell you a new roof is needed. Reviewing preliminary care plans from a few different companies should ensure that the providers are offering a similar scope of services to cover your needs. Caregiver Selection The initial consultation process also helps the agency determine which caregiver(s) would be the best fit for a client’s situation. During this meeting, it is important to communicate your needs and who you are comfortable with having in your home. Caregiver preferences can be difficult to discuss, but they are an important part of making sure your home care experience is a successful one. For example, if your loved one has Alzheimer’s disease, a home care company should narrow down your selection to caregivers who are experienced and trained in dementia care. Furthermore, some clients are more comfortable with caregivers of a specific gender or ethnicity or require someone who speaks a language other than English. Some companies also offer interviews with selected caregivers after the initial consultation and before services begin. This ensures their skills and personality will be a good match with the person receiving care.
0 Comments
Amazon's New Alexa Together is an Aging-in-Place Solution Amazon’s fall 2021 event certainly didn’t disappoint, showcasing everything from a new wall-mounted Echo Show to an Amazon home robot (no, really). But the company is also adding new services to its lineup, including a brand new Alexa ability called Alexa Together. While services like Alexa Guard focus on security, Alexa Together is specifically targeted to those aging in place, seniors who are remaining in their own homes or moving into independent living situations like granny pods. It works with a variety of Amazon devices and is compatible with third-party monitoring devices as well — such as some fall detectors — so it can draw Click to find out more in data from multiple sources. Key features include: Care alerts sent to family members or caregivers when it looks like something has gone wrong, such as a potential fall or accident in the home. An Urgent Response option that can connect seniors to a 24/7 emergency helpline. This hotline can be accessed hands-free in case of an accident and is also compatible with third-party detectors. This will also send alerts to emergency contacts. A Remote Assist feature that allows caregivers to send messages directly to a device like an Echo or Echo Show. Remote Assist lets loved ones do things like set reminders to take medications or link up favorite music services and add contacts so that seniors don’t have to worry about setup steps like those. Adult Diapers and Incontinence Products Resources, information and advice from caregivers about selecting and using adult diapers to Discover more deal with urinary or bowel incontinence. Managing Incontinence at Home Adult incontinence is a common issue experienced by older adults as their cognitive or physical condition declines due to age or illness. Adults who are dealing with urinary or bowel incontinence use products referred to as "adult diapers" for discreet, disposable protection. Managing the personal and household challenges incontinence accidents create can be a significant source of stress for caregivers. To help families find solutions for making daily life with an incontinent adult easier and more comfortable, AgingCare has created the following list of resources and articles about adult incontinence products. Incontinence Support Forum For general support, tips and advice from other caregivers with experience in selecting and using adult diapers, browse the informative posts offered in the Caregiver Forum. Members discuss their experiences, share ideas and offer their best advice on using products like adult diapers, waterproof bed pads, booster pads, bedside commodes and condom catheters. New insurance policy exclusions are putting home care agencies at risk The COVID-19 pandemic is putting home care and home healthcare agencies at increased risk of liability from client lawsuits due to communicable disease exclusion clauses that insurance companies are adding to their policies. Odell Studner Insurance broker Gavin Studner advised home care agencies to check their policies carefully for the exclusions. He suggested this Friday during a Care Academy webinar on liability risk during the pandemic. “In the case of COVID, (the policy) won’t provide coverage if the client sues SonderCare - medical beds for rent you as the homecare agency, alleging that they contracted COVID from your caregiver,” Studner said. “This is important because even if it is a completely false claim, the carrier no longer has the duty to defend your claim and pay on behalf of your legal fees. As we know, legal fees can rack up, especially in our court system. Studner said insurance companies began adding communicable disease exclusions to policies this year and some home care agencies are unaware of them. While some states don’t allow the clauses, Studner predicts most will in the near future, putting even more home care agencies at risk. To mitigate the risk of a liability, Studner warned agencies to tighten safety protocols, ensure client visits are all carefully documented, educate staff on the importance of the COVID-19 vaccine and encourage them to get the shots. “We have found that about 80% of our clients’ caregivers are vaccinated and educational material does help,” Studner said When Laura sent me an email in early August, the first thing she did was apologize. “Please excuse how inelegant and disjointed this will be,” she wrote. “It matches my brain after being a caregiver since 2013.” In 2013, Laura was several decades into a career as a marketing consultant. Her work was rewarding and challenging; she felt like she got to be creative every day and was never bored. She had gone freelance in the early 2000s and reveled in the freedom of being her own boss. Then her 78-year-old mom began experiencing severe back pain. She was scheduled for surgery, but the symptoms only worsened after the procedure. She was soon rushed back to the hospital following the collapse of her spinal cord. After emergency surgery, her pain lessened, at least somewhat, but then Laura was left to deal with her mom’s quickly accelerating dementia. “She went from normal cognition to thinking it was her wedding day and that I was her mother,” Laura told me. “She didn’t know how to walk, and didn’t remember what had happened to her.” According to elder care experts, Laura’s description of what happened to her mom is pretty common. As someone ages, their health appears to gradually deteriorate in a way that doesn’t seem alarming. Most of the time, though, they’re inching toward a cliff — and when they fall off, they find themselves on another health cliff, and another, and another. With each cliff, it gets more difficult for a family member to catch them. Some older adults have diligently prepared for their future. They purchased long-term care insurance when it was still affordable, then paid the premiums each month, even as they continued to rise. This is not the norm. Many adults have no plan at all, or assume that Medicare, which currently kicks in at age 65, will cover their health costs. Medicare, however, doesn’t cover the long-term daily care — whether in the home or in a full-time nursing facility — that millions of aging Americans require. For that, you either need to pay out of pocket (the median yearly cost of in-home care with a home health aide in 2020 was $54,912, and the median cost for a private room in a nursing home was $105,850) or have less than $2,000 in assets so that you can qualify for Medicaid, which provides health care, including home health care, for more than 80 million low-income Americans. Even if you qualify, the waiting list for home care assistance for those with Medicaid tops 800,000 people and has an average wait time of more than three years. That’s how millions of Americans find themselves in situations like Laura’s. A nursing home is too expensive; or, because of ongoing staffing shortages, there aren’t even open beds in the area. Over the past year and a half, many have also deemed them too risky because of Covid-19 concerns. In-home care seems more complicated, but it’s almost always what the care recipient wants, especially if it means the ability to stay in their own home. So the family decides to make it work, without a real understanding of the often-invisible costs that will quickly begin to accumulate. “My mother and I had always been close, as much friends as mother and daughter,” Laura told me. Laura thought, with the freedoms of her job, she could manage care for her mother at her parents’ home, even if it meant slightly decreasing the number of clients she took on. “Looking back, I realize how naive I was,” she said. “My clients dropped away, some after more than 20 years of working together. You can’t care for someone with such high needs and still manage to put in a day of work.” “It’s a weird sort of amnesia I’m left with. I think this is PTSD.” In the years that followed, Laura’s mother broke her hip. Her dementia worsened. Her father was also diagnosed with dementia, and would occasionally hit people. Laura attempted to go along with their realities to avoid agitation, which made her feel like she was living in “this weird, make-believe version” of the world. Without any outside help, she felt herself receding into an automated routine of changing diapers, bathing, washing bedding, cooking meals. The feeling was not dissimilar from caring for a baby, only babies get older and their care gets easier. The opposite is true for elder care. “Watching people you love suffering is debilitating, but you have to keep going,” Laura said. “That’s just another thing you tamp down. You have to stuff away anything you’re feeling because there isn’t time for that. You have too much to do.” Her parents’ medical needs kept getting more intense, but as is the case with so many elders “aging in place” — living in their own homes, which AARP found the vast majority of older adults prefer — or moving in with a family member, they were too much for Laura but too little to justify (at least to insurers, or Medicare) a full-time nursing facility. Laura’s mother died last year. Her father died four months ago, but not before developing kidney cancer that eventually did necessitate nursing home care. Once there, he became so agitated and combative that the staff required Laura to sleep in the room — in the middle of an active Covid-19 outbreak — just to keep an eye on him. After he died, in what Laura described as a “crazy mess of death,” Laura found herself with a decimated retirement account, no other savings, and no income. “I’m 63, and need to find a job,” she said. “But who wants a 63-year-old? I can’t even manage to put together a decent résumé. I’ve gone from a strong, confident woman who could handle anything to someone who can barely function.” Over the past eight years, Laura lost much of her support system; she couldn’t go anywhere, couldn’t socialize, couldn’t maintain friendships. She can’t remember what her family used to be like and keeps replaying scenes in her mind, wondering whether she could have provided better care. “It’s a weird sort of amnesia I’m left with,” she said. “I think this is PTSD.” Depending on your own experience with elder care, Laura’s case might sound extreme. But it isn’t, not really. It’s just that most of this care work — both paid and unpaid — remains invisible. According to the most recent data from the AARP, an estimated 41.8 million people, or 16.8 percent of the population, currently provides care for an adult over 50. That’s up from https://www.sondercare.com/evergreen-approach/ 34.2 million (14.3 percent) in 2015. Of those caregivers, 28 percent have stopped saving, 23 percent have taken on more debt, 22 percent have used up their personal short-term savings, and 11 percent reported being unable to cover basic needs, including food. The average age of someone providing care for an adult is 49, but 23 percent are millennials and 6 percent are Gen Z. Sixty-one percent are women, and 40 percent provide that care within their own homes, up from 34 percent in 2015. A lot of these caregivers are really, really struggling. What’s required of them is more complex and time-consuming than just 10 years ago, as caregivers deal with overlapping diagnoses related to physical health, mental health, and memory loss as the elderly live longer. The work is much more than just clearing out the guest room or setting another place at the dinner table. Depending on the health of the care recipient, it’s monitoring medication, preparing special meals, changing diapers, and bathing, plus figuring out finances, providing transportation to and from medical appointments, and more. But only three in 10 have additional paid help, and 27 percent struggle to hire affordable care in their area. One in four caregivers find it difficult to take care of their own health, and the same percentage report that their health has deteriorated because of caregiving. So much of the labor — and struggle — associated with caregiving goes unnoticed, unappreciated, and underdiscussed So much of the labor — and struggle — associated with caregiving goes unnoticed, unappreciated, and underdiscussed. There’s a whole host of reasons for that, mostly the fact that family caregiving is largely performed by women in the home and thus discounted as labor; when it is paid, it’s almost entirely performed by women of color, particularly immigrant women, and socially devalued. Then there’s the fact that most Americans are also terrified of death and the dying process and horrible at talking openly with others about the realities of aging. As Laura’s story demonstrates, that sustained invisibility has cascading consequences on not only the caregiver’s mental health but also their capacity to save for their own eventual care needs. Paid caregivers’ situations are different but no less extreme. In most states, they have close to no labor protections for incredibly physically taxing work. Most barely earn enough to provide for their own families, let alone save for retirement. Since the difficulty of this care remains largely imperceptible to all save those who provide it, there have been few attempts, governmental or otherwise, to make it better, easier, or less of a life-swallowing burden. Right now, there are resources for the poor (who go on Medicaid, the services for which have become harder and harder to access and arrange) and resources for the rich (who can pay for Cadillac versions of care, including consultants to navigate the process). For everyone in between, as Caroline Pearson, senior vice president at the University of Chicago’s NORC (formerly the National Opinion Research Center), put it to me, “There is no system at all.” There are just individual families and the caregivers within them carving out their own paths as best as possible — and, in many cases, significantly denting their savings and earning power, making their already precarious footing in the middle class all the more so. How do we make this labor visible enough that we can begin to make it navigable and to prevent, or at least significantly alleviate, millions of care situations like Laura’s? Our current elder care reality has everything to do with who’s done this labor in the past, paired with an enduring unwillingness to update social policy to match seismic societal shifts. There’s a way to value this work. The first step is seeing it not just as valuable labor but as labor in the first place. When academics and analysts put together surveys to try and figure out just how many hours people in the United States spend providing care, they have to be clever. “You and I, in our conversation, we’re using this word ‘caregiver,’” Christian Weller, an economist who studies retirement, told me. “But the people who design the surveys, they have to be very careful not to use that word.” According to Weller, many people, particularly those caring for family members, will say, “Oh, I’m just spending time with my mom” — they just happen to feed, bathe, and supervise all their daily needs while doing so. The people providing this care don’t think of themselves as caregivers, for many of the same reasons mothers who don’t work outside the home don’t think of themselves as “working moms”: The labor they do is expected, part of their familial role. It’s not labor, or at least not the sort of labor that would earn its own title like “caregiver.” Caregiving is work, even if our society has historically concealed that work. For much of the country’s history, the question of who provided long-term care — for young children, for those with disabilities, and for older people — was simple. Women did it for free in the home. The vast majority of men worked outside the home, earning the money that would allow the household to run, and then the women ran it: cooking, cleaning, educating, supervising, bathing, planning, organizing, and just generally doing the labor known as care work. While men’s work outside the home was valorized, women’s work was naturalized: It wasn’t work, it was just what women did. “Elder orphans” is the phrase du jour in the elder care industry. It describes seniors who are single or widowed and have no children (at least locally) and no support system. They find themselves living alone in the community with no one to help care for them should they need it. This group of “orphans” will increase sharply as baby boomers age and as average life expectancy in the United States continues to stretch toward 80 and beyond. While there are many reasons for the growth in the number of these “elder orphans,” one of them is that we have become a mobile society. Some people move to be closer to their children and grandchildren. Sometimes it is because they themselves need help or want to be near those who can provide assistance with activities of daily living (ADLs) like bathing, cooking, dressing, using the bathroom and other activities that are done regularly as we age but can become difficult if not impossible to do alone. Other times relocation is sought because seniors simply want someplace new where they can live without sharing walls with family members – especially teenagers! Still, others relocate for work or health reasons. The result: more and more older Americans will find themselves alone – without a support system or a county home to go to for assistance. There are many ways to address the problems facing our elder orphans, including creating more publicly-funded senior centres where they can get together and socialize; setting up transportation services so they can have easier access to their friends in the community; instituting the Baby Boomer Bill of Rights legislation that creates protections against nursing home placement when it isn’t medically necessary, and ensuring that public transit systems meet the needs of all segments of our population. But we also need to keep working on other solutions like Watchdog Angels™, an interactive GPS tracking service that allows family members or caregivers (such as local Caring Communities) instant access via cell phone to the location of an older adult who might be in distress. People can download the free app onto their mobile phones and use it to follow a loved one’s every move. The app uses GPS signals, WiFi access points and cell towers to triangulate a person's position for up to 90 minutes. It alerts not only relatives and caregivers, but also public safety agencies like 9-1-1 dispatch centres so that they can send help if needed in a timely manner. Seniors who choose this system have told us that it reduces anxiety and loneliness – which are often felt by seniors living alone – because someone always knows where you are and what you are doing. The idea of aging in place is a big one. It means that even when you can no longer take care of yourself, you want to maintain your independence and stay in your home as long as possible. But how do we make this happen? In this blog post, I'll give you some tips on how to plan for ageing in place so that it's an easy transition! Are you looking to age in place? You can stay at home longer before needing outside help with these skills. It's also a good idea if your children or grandchildren want to move out! With these skills, you'll be able to continue living independently while they're away. Aging in place is a great way for seniors and their families to save money and have more time together. Click here for more information on how aging in place could work for you! As a caregiver, one of my most important duties is helping seniors age in their homes safely while maintaining their dignity and independence for as long as they're able through checkups and consultations with doctors. If there are any signs of trouble during routine visits, we'll work together on adjusting care plans based. Planning for the future: what to do, where will you live? - Choosing a home that suits your needs and lifestyle. - Making it feel like home with some simple but essential design changes. - Planning around daily living tasks such as cooking or washing clothes. - Necessary remodeling; house modifications? Changing rooms into spaces you can access independently, like an adult playroom at the bottom of the stairs so they don't have to climb any more steps then necessary! A bathroom on the ground floor is also helpful if not in a wheelchair. If needed there are products available to help make them easier to use (grab bars). Or installing ramps outside their homes which greatly reduces Remember to maintain your independence and stay in your home as long as possible! Click here if you want more information about ageing in place or call us at (555)-999-9999. We look forward to hearing from you soon! |