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Posts Tagged ‘Home Health Care’

The number one reason for needing home health is when care of an elderly person becomes too much for family members to bear alone. This is especially true with those patients that need special care due to illness.

Alzheimer’s disease is a tragic slow deterioration of someone’s mental faculties. With this disease people often lose the ability to care for themselves. It quickly overwhelms family members and they turn to help. Home health care for the elderly is one of the answers to this problem. A home health care nurse can help with daily monitoring of these patients. Often an Alzheimer’s patient will tend to wander and get lost. Home health nurses are able to be an extra pair of eyes in this event.

Many times elderly patients don’t want to live in nursing homes or retirement communities. This is another reason for home health care for the elderly. It gives the patients a sense of self to know they can stay in their home instead of an institution. It’s common for these people to have living wills and instructions for their final times. Home health nurses are often saddled with the responsibility of making these difficult decisions when the time comes. From that moment on they stay in the home full time until the death occurs.

Aside from physical care, home health care for the elderly can provide emotional support for the entire family. This is a trying time for all involved and it’s not unusual for it to be the first experience with death for many. Add the fact that it’s a parent and the family is often grieving before the actual death. Home health nurses have been trained in grief counseling and emotional support. They’re by no means professionals in that field but they certainly understand how to handle someone going through these tough times. They often get emotionally involved in their patients as well, so they mourn the passing with the family.

Home health care for the elderly has no set time limit. Usually the nurses are called in for the last weeks or months of someone’s life. Sometimes this assignment can last for years. Nobody can definitely pinpoint how long a disease will last or when someone’s time is up. This is why dedication is extremely important. People who can’t handle it are weeded out quickly, leaving only the best in the field. Families depend on their home health nurse for guidance and support. It takes a truly special person to be able to shoulder these responsibilities.

There are a few common places that many families use to recruit home health aides. The most frequently used sources are:

-Independent Living Centers

-Your doctor’s office

-Nursing Schools

-Physical Therapy Schools

-Vocational Schools (Including Certified Nursing Assistant programs)

-A home health-care agency

-State Department of Developmental Disability or County Vocational Rehabilitation

-Ads in local newspapers/classifieds

-Bulletin boards at schools, community colleges, places of worship, etc.

-Word of mouth

-Craigslist.org

Centers for Independent Living (CILs) often provide training programs for home health aides. CILs assist people with disabilities to live independently and offer information on managing personal assistants and a referral service. As with any other referral service, you should check the references and do an extensive interview on personal assistants. Similar programs are offered in rural areas called programs for rural independent living.

Senior centers can also be valuable resources as many maintain a list of people willing to do attendant work. If you have sough medical attention in the past, your physician, social worker, rehabilitation therapist, or other medical staff may have information on home health aides.

You may also want to contact nursing schools in your area either directly or posting job listings on their bulletin boards. Nursing students are frequently looking to gain experience and will likely view your care needs very seriously.

In the case that you do not find an adequate home health aide, you can always use an agency. The employees provided by the agency are usually more trained. In the event that you PA quits or takes a leave, agencies provide immediate replacements. Agencies provide insurance coverage and benefits to their employees which contributes to a more stable workforce. The downfall of using an agency is that you do not have as much freedom to choose your assistant as hiring independently, and much of the time there are restrictions on the tasks that their HHAs can do. Agencies are often much more expensive than hiring independently.

Many people have been successful using Refugee agencies. You can offer training in English as part of a benefits package. They sometimes offer additional support and training.

Finally, word of mouth is a powerful recruiting method. Ask family members and friends who have sought care in the past. Ask them about their experience with the HHA, but remember to do your own research and background check on the individual.

Home Health Care in Los Angeles

Home health care is health care that is provided to patients inside their home, and usually by either health care professionals or family and friends. The term “home care” suggests that the care provided is non-medical and more of a custodial nature, whereas “home health care” may suggest licensed staff members. The differences here are similar to the differences between assisted living facilities and nursing homes. Much like assisted living facilities, home health care lets seniors enjoy a good measure of independence. An elderly individual or couple will appreciate having privacy as well as assistance in daily living needs.

What Home Health Care Provides

What kind of services does home health care provide? Home health care may help seniors with daily living needs such as bathing, dressing, house keeping and cooking and dining preparation. Depending on the needs of the resident, there may be special provisions such as transportation services and errands, volunteer programs, exercise and walking, and toileting assistance. More extensive forms of home health care would also provide rehabilitation programs, including visits from physical therapists and nurses. Other qualified home health care professionals may include respiratory nurses, occupational nurses, social workers, mental health workers and physicians.

Who pays for home health care? This type of outside assisted living program can be paid by private resources from the resident or family, by public payers such as Medicare and Medicaid or by employer-sponsored health insurance plans. Medicare will usually not pay for home health care on a long term basis while Medicaid is more likely to help low-income families with little or no assets. Employer-sponsored home health care is likely to be on a short term basis unless the insurance plan is very generous. Most of the time home health care will be paid for by a family’s own resources.

Comparing Home Health Care with Assisted Living

How does home health care compare with in-house stays at nursing homes and assisted living facilities? Most seniors would prefer home health care, of course, as people always do value their privacy. However, there are also circumstances that would necessitate constant supervision of the resident at an assisted living facility, and not only occasional visits. Home health care is basically assisted living, but with even more independence. Therefore a resident that cannot be left alone for long periods of time would be better suited in a nursing or board and care type home.

It might appear that home health care would be cheaper than a stay in a nursing home. However, home health care costs can be just as expensive, depending on the number of hours aides work. Some residents have admitted that full time home health care usually costs twice as much as a stay in a board and care or assisted living home. Most home health care agencies will charge about $20.00 an hour or over. If the resident is relatively independent then the fees associated with the service can be controlled. However, don’t forget that if your needs are minimal to begin with, you could hire a trusted individual to perform the same tasks and save money from paying an agency fee.

Home health care is ideal for seniors who feel well and can easily get around but who need occasional doctor visits and help with housekeeping. It is also a preferable choice if a senior needs full time care but does not want to become a resident in a public nursing home. Full time home health care provides the most privacy and personal attention possible. If you are looking for this type of senior assistance, you should always be mindful of the qualifications of workers, as opening one’s home to a stranger could always be a security risk. The best home health care agencies have screened workers who are well qualified in their field.

How We Can Help You

ElderHomeFinders is a company dedicated to helping seniors locate assistance in the southern California area. We inspect assisted living facilities and retirement communities in the area so that our clients will find the perfect home at a price they can afford. Can ElderHomeFinders also help seniors find home health care? Yes. Our company can put you in touch with the right home health care agency, according to your special needs and budget limitation. We can also advise you on the differences between home health care services and assisted living and board and care facilities and which choice would better work for you. Seniors have worked hard all their life and surely deserve the best health care possible – whether in a senior living facility or in their own home.

With the financial situation in the US the way it is presently and the need to fix foreign affairs, health care takes a backseat. The mortgage lending situation undoubtedly, needs careful attention but what happens to health care. The situation in home health care is still shaky to say the least. Family caregivers already have to deal with plenty in terms of estate planning, navigating the Medicare and Medicaid maze, as well hold jobs in the case of many squeeze generation women.

The truth is, America as a nation is aging. The first of the baby boomer generation is turning 65 in the year 2013. With the aging of America, we need to expand the amount of home health care solutions available to seniors. This means more cash and counsel programs, expanded assisted living arrangements, more community living programs, and adult day care. Home health agencies are not for everyone. True, it is a much more financially viable solution than nursing homes, which can cost up to 70 thousand dollars a year.

Everyone wants to retire and age in the comfort of their own home. Not many people want to age in nursing homes. The problem with home health agencies is the limited scope of responsibilities each assistant is allowed to attend to. Many home health care agencies have strict criteria that exclude things like bowel care and help with trach tubes, both things that are essential in family with MS or other brain-impairing diseases. The alternatives are hiring independently, hiring family, or neighbors if the situation allows it. When you consider home health care, the main considerations are financial and quality of care. Do you receive financial aid either by Medicaid or some other outside funding? Do you need professional nursing home type care? What is the extent of disability?

Home health care businesses are becoming more popular these days and may offer a range of services. They are usually relied on by the elderly, those who have disorders which limit their movements and require constant medical attention, or those who are recuperating from an illness or from surgery. Their services include proper health management, meal planning and preparation and may even include light chores such as keeping the house clean and running some errands. Home health care businesses are quite easy to start cost-wise since they only require minimal start-up costs and may even be started from the house, which obliterates having to rent your own space.

Although it helps if the prospective business operator has a background in health care, home health care business operators are not required to be trained formally in areas of health care. There are countless operations manuals and books available which operators may use to gain information about the business. They can also opt to attend intensive training programs where they will experience the business directly. These training programs also offer support after the business has started.

Home health care services usually offer non-medical home care service. These providers cater mainly to the elderly and the disabled so they can remain safe and secure in their homes. These services are focused on personal care and cover daily living activities such as companionship, supervision, medication reminders, light housekeeping, and transportation.

The nature of home health care businesses and the services that they offer can be done by anyone. However, a lot of caregivers in the home health care business preferred by business operators are retired nurses and nurse assistants. They know a lot about quality health care, yet no longer actively practice in a doctor’s office or hospital. Also, the demands of providing home health care are much lighter than those in hospitals and clinics. They do not follow strict schedules, and as such, enable retired nurses and nurse assistants to pursue their other interests while still earning money upon retirement.

It always makes me sad to hear the families of an elder say “Mom made me promise to never put her in a nursing home”. That is simply a promise that most families today cannot keep. If a caring son or daughter finds that they have to break that promise, they may feel guilty for the rest of their lives. Mom probably asked for that promise because the nursing homes she remembers were dark, institutional places which would be considered substandard in America today. Today’s family structure and the financial challenges of elder care, make facility living a very common choice. When an elder shows signs of not being able to perform the basic activities of daily living, families or concerned professionals must step in. It is actually against most state laws for a professional to be aware of an elder in trouble without taking some reasonable action to secure their safety. There are many indicators that an elder is no longer safe at home alone. The basic litmus test is to ask yourself is: “Could this person save him or herself if their home were on fire? Would they be able to call 911 and communicate their exact location? If left alone for any period of time are they at risk for physical abuse or financial exploitation? Do they have the skills and resources to meet their daily hygiene and nutritional needs? The answer is “NO” for many American elders who live home alone.

Independence vs. Isolation

Many of my elderly clients who were trying so hard to maintain their independence by living alone at home actually maintained nothing more than an isolated existence punctuated by the occasionally call or visit from friends and family. This type of isolation was also coupled with medication errors or abuse, self neglect and unsanitary housekeeping. A person living in this situation will often “bloom like a flower” in the right retirement facility environment. It is amazing what three hot meals a days, social interaction, clean sheets and regular administration of medications can do for a person’s mind, body and spirit. A person who lives alone is more likely to fall and lay alone on the floor for days without being found. A person, who lives alone may make poor choices such as keeping, (or worse,) spoiled food in the refrigerator. If a person lives alone, there are many signs of illness that no one will notice during sporadic short visits. Medical appointments may be missed and prescriptions left unfilled. Many people feel that they are honoring their aging loved one by letting them live alone, even though all the tell tale signs of self neglect are apparent. There is no honor or dignity in being found on the floor after one has laid in their own excrement for three days. Unfortunately, many families will wait for this type of incident before insisting on either home health care or facility placement. If an elder is physically or verbally abusive to family and care givers, they are much more likely to be left alone to make their own decisions, regardless of how dysfunctional their situation may be. Elders with difficult personalities are many times more likely to be abused by caregivers. They need more supervision, not less.

American Family Dynamics and the Pressures of Today’s World

I hear people say “Americans don’t take care of their elders like other countries do”. Well that is not my experience. The adult children who consult with Geriatric Care Manager or other eldercare professionals are very concerned about their parents. They love them and they want the best care their money can buy. That’s the clincher: what their money can buy. In America, caregivers, maids, etc,, are expensive. Perhaps in another country where slave labor is commonplace, people can afford plenty of care. But in this country it costs $12.00 per hour (or more) for a home health aide. At eight hours per day, that is $96.00 per day. That is $2,880 per month or $34,560 per year – more than the average working American earns per year. The average woman gets a social security check of less than $500.00 per month. Do the math and you will soon see that unless you are wealthy, many people cannot afford to keep their elders in their own home with a part time caregiver or even in their children’s home with a caregiver.

Now couple this financial problem with another very real problem. Most middle income women in their fifties, who are caring for their elderly parents, are also trying to hold down a job, help their young-adult children and maintain a marriage. If a middle income woman stops working to care for her parents, she and her husband either cannot pay their bills or they must significantly reduce their standard of living. I know a few husbands who are fifty-something and feel they have worked too hard and too long to have their dreams of retirement evaporate because someone else’s needs are suddenly more important than their own. Now that Americans have come to grips with the concept that it takes two incomes to live well in this country, they are more determined than ever to have a retirement. Paying $35,000 per year for a caregiver can take a huge chunk out of the retirement savings. Frankly, most people couldn’t afford to do it even if they wanted to. Because most Americans’ net worth is in the equity of their home, selling the family home is the most common way to finance elder care services. If the family home sells for $100,000.00 and the average cost of an Assisted Living Residence is $36,000.00 per year, an elder can afford to live in that Assisted Living for 2.7 years. Coincidently, the average amount of time a person lives in an Assisted Living before moving on to a nursing home is 2.5 years.

Many adult children, who do have the desire and financial means to bring their elders to live with them, still cannot. They cannot because the medical or psychological needs of the elder are beyond their capacity to manage. For example, if Grandma is sweet and docile by day, but “sundowns” or grows agitated as evening falls, this poses a difficult problem for the caring family. When some people experience dementia or other medical issues, they may stay awake all night. They sometimes wander out of doors or rummage through drawers and closets. This behavior will keep the whole family awake at night. If a working family cannot sleep at night, this situation will become intolerable very quickly. Some adult children have been raised by violent, aggressive parents who are now violent aggressive elders. Children who have been raised under these conditions need not feel obligated to bring their parents to live with them, despite the pressure they may get from outsiders who do not know the real story.

Elders and their families who are trying to make difficult choices about elder care benefit from a professional assessment from a geriatric specialist. Professional care managers can offer an objective opinion based on a clinical evaluation of the physical and cognitive status of the elder. Physicians, hospital case managers, facility admissions coordinators and social workers can also offer advice about appropriate placement of an elder or even suggest how to set up services in the home to best meet the elder’s needs.

Home Health Care – Stay Home without Being Alone

At the very least, any elder living alone should have a medical alert system. This is a necklace or wrist band with a panic button that can be pushed in case of emergency. If the button is pushed a dispatch center receives the signal and makes and attempt to communicate with the elder through a speaker placed in the home. If the elder needs help or does not respond to attempts to communicate, emergency services will be dispatched to the home. Many services will also contact friends and family to notify them that assistance is needed. A good candidate for this device is one WHO DOES NOT have memory loss as memory loss makes it difficult to learn to operate new appliances.

There are two basic types of home health care services: Medicare and Private Duty:

Medicare Home Health is free but can only be accessed if ordered a physician. Medicare will only authorize the free home health services if specific events have happened such as a recent hospitalization lasting three or more days, or a recent change in health status, etc. Medicare will send a Registered Nurse to evaluate the elder and that nurse decides if other professionals such as physical therapists, social workers, dieticians, etc. should perform evaluations. Each professional will determine what services they will render and for how long. Medicare services are temporary in nature and are not offered on a full time basis. The average visit by the nurse, aide and therapist is less than one hour each. Even Medicare home health aides only stay long enough to bathe and dress the patient.

Private Duty Home Health can be arranged on a full time, part time or live- in basis. Many Long Term Care Insurance policies will pay for home health care. The amount of care one can get and the duration of the services varies depending upon which policy they purchased. If someone does not have insurance, they must pay out of pocket (or private pay) for any services. Typically a private home care agency will offer services at a minimum of four hours per day. Typical eight hour shifts are 7am-3pm, 3pm-11pm and 11pm – 7am. Many elders complain that an agency sends them a different caregiver each day. In order to avoid having the same aide, that as much as possible, order care every day for at least eight hours. This will allow the agency to schedule the same person for all your shifts. Because labor laws do apply and the agency would have to pay overtime for time which exceeds 40 hours per week, you will most likely have at least two to three caregivers on a full time case. The average hourly rate is $14.00 per hour. A live-in will cost about $150.00 per day. A live-in lives in your home and drives your car (or theirs for a mileage fee) and you are expected to feed them as well, even if you go out to dinner. By law, a live- in is entitled to two hours per day of free time. They can do what ever they like, including leaving the house during their break. If this arrangement will not work for your situation, consider hiring an aide around the clock. Around the clock care is typically delivered in two twelve hour shifts which are done by two different caregivers.

One aide comes to the home from 8am until 8pm and is relieved by the second caregiver at 8pm until 8am. Around the clock care can be delivered in many schedule formats. A live- in is expected to have their own private bedroom and bathroom although many agencies are flexible on this issue. The live- in is expected to be awake all day and have at least 7 hours of sleep at night. If the elder does not sleep at night, a live- in arrangement will not work. One option is to have the live in ($150/day) plus hire a caregiver to come to the house and stay up all night with the elder ($14.00. hour for eight nighttime hours). This costs $112 + $150= $262.00 per day. The only other alternative is to have around- the- clock care which will cost $14.00/hr X 24 hr=$336/day. Adding the eight hour night shift to the live in, saves about $3,000 per month. The Veterans Aid and Attendance Pension is available to qualified veterans who need a caregiver in their home on a regular basis.

Types of Adult Housing and Facilities:

Independent Living Facilities usually offer small apartments with some meals included in the price. A person who lives in an Independent Living Facility is expected to manage their daily care needs on their own, but the staff would readily recognize if needs increased and assist the resident in obtaining the needed help. Some facilities have extra care services available for additional charge to help the resident “age in place.” Others may ask a resident to move out if their needs exceed the scope of that particular facility. Limited transportation is usually provided although many residents are still driving when they enter an Independent Living Facility. These facilities may cost anywhere from less than $1,000 per month to over $5,000 per month depending upon the luxury amenities and location.

Assisted Living Facilities usually offer hotel size rooms with the option to share a room or pay extra for a private room. Three meals and snacks are usually provided as part of the price. Residents are expected to need some assistance with their daily care needs. Medication administration is strictly supervised. The State laws dictate who can live in an Assisted Living. The State does not want Assisted Living facilities to house nursing home candidates or Nursing Homes to admit people who could function just as well in an Assisted Living Facility. Assisted Living residents must be able to walk and transfer ( from bed to chair or chair to standing) with the assistance of only one other person. An Assisted Living resident can be left alone in their room for two hours or more. Nurses aides are on duty around the clock. Registered nurses or Licensed Practical Nurses are on duty at least during the daytime. Many medical services may make rounds and visit residents at least monthly. It is not uncommon for an Assisted Living resident to never have to leave the building for a medical or beauty appointment. Prices may range from under $1200/month to over $8,000/ month, once again depending upon the amenities. Medicaid has a program called the Medicaid Waiver which can pay part of the cost of the Assisted Living. However, funds have been historically limited and waiting lists can be long. The Veteran Aide and Attendance Pension is designed to financially assist qualified veterans who need the services of an Assisted Living facility

Dementia Specific Facilities are designed especially for the memory impaired resident. The building, floorplan, furnishings, d