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Table of Contents Labor of Love... 3 You Are Not Alone... 5 Responsibilities... 6 Rally Your Resources... 8 Plan to be Organized... 8 Explore Work Options... 8 Consider an In-Home Caregiving Service... 8 Time for Help... 10 Key Questions... 11 Institutionalized Caregiving vs. Home Health Care... 12 How to Indentify a Quality Home Health Care Provider... 14 Talk to Your Loved One about Home Care Services... 18 Long Distance Caregiving... 20 Take Time for Yourself... 22 What to Expect on the First Day... 24 Aging and Caregiver Resource Information... 27 If you are one of the millions of Americans caring for a family member, a spouse or friend, you know it is truly a labor of love. It is so much more than simply providing help with daily living. You are a supporter of their independence and guardian of their dignity. The emotional well being of your loved one is just as important as the physical well being. 2 3
Labor of love. There are more people in a caregiving role than ever before, as life spans continue to increase. Many people find themselves shouldering the responsibilities of caring for both their children and their parents. A home health care provider can be a partner in caring. There are many reasons to opt for additional assistance with caregiving responsibilities, and there are many professional caregiving services available. Home care is not just for the elderly. It can benefit those with long-or short-term illnesses, injuries, physical handicaps, mental health disorders and chemical dependencies. Choosing a home health care provider that is an extension of your role is essential to your peace of mind. If a caregiving service puts the emphasis on your loved one, not the bottom line, the rewards can be enormous. Quality caregiving is based on a mission to serve. You Are Not Alone If you have taken on a caregiving role, you know that it is not without struggles. Others share your struggles. According to a 2004 study by the National Alliance for Caregiving and AARP, more than 44 million Americans are responsible for the care of a family member or friend. Studies show that this number is expected to sharply increase in the state of Ohio. According to the Scripps Gerontology Center, it is estimated that between 2015 and 2050 Ohio s older population will increase from 1.7 million to 2.9 million, an increase of 70 percent. Some studies show that nearly half of the working population is expected to be in a caregiving role within the next few years. That is a lot of responsibility work, family and caregiving. Lisa Smith, founder of Community Caregivers, a home health care provider with offices in Hartville, Canton, Cuyahoga Falls, Green, West Akron, Canfield and Medina, sums up her work as families taking care of families. Quality of life is as important as day-to-day tasks, such as bathing, preparing meals and medication reminders. To maintain its mission of serving others, Community Caregivers looks deeper into each client s situation to discover what constitutes a quality of life for that individual. For some it may mean the freedom to practice their faith, for others it may mean watching their favorite team play on TV or enjoying their pet. One of the benefits of an in-home caregiving service is the ability to maintain continuity in the life of the person needing care allowing them to go on living, and enjoying what is meaningful to them. 4 www.commcareinc.org 5
Balancing Your Responsibilities There are many tasks that may fall to the caregiver, including care of pets, financial matters and upkeep of the home. Often it amounts to running two households which can be an overwhelming task. 6 www.commcareinc.org 7
Responsibilities Rally Your Resources Caregivers are often hesitant to ask others to help, yet many people have resources around them. Now is the time to rally those resources. Ask other family members or friends if they can pitch in. Plan ahead for unexpected situations that arise in your life an illness, or additional work or travel for your job. If you enlist others to help in advance, you will be less tense about calling upon them when needed. Plan to Be Organized Maintaining a list of your loved one s emergency contacts, medications and dosages, and financial/insurance information can save time and additional stress should a situation require hospitalization or emergency medical care. Keep this information at your fingertips. It will allow you to focus totally on your loved one in a time of crisis. loss of wages and social security benefits can be significant. A reputable service can help offset some of the caregiving work, so that family members can continue to remain viable at their jobs. Community Caregivers staff members consider themselves extensions of the families they serve, so even the everyday tasks of running a household are part of the individualized care plans. They put together meal plans, shop for groceries, make veterinary appointments for pets and even take the pets to those appointments. They might help plan a lunch gathering of friends at the home, make the calls to invite and then prepare the meal. Whatever is important to the individual is included in the care plan. Explore Work Options Perhaps you are feeling the pressure of juggling caregiving with a full- or part-time job. A recent MetLife Market Institute study found that a significant portion of the working population either quit their jobs or retired early due to caregiving responsibilities. Today, there are more options than ever for employees. To retain and recruit good workers, many employers have begun to offer eldercare benefits providing counseling, seminars and even backup care for their employees. Flex-time is another option that you might want to consider, if your employer offers it. Consider an In Home Caregiving Service Many people have turned to professional in-home services to assist them in meeting work and caregiving responsibilities. Studies show that the impact of early retirement in terms of 8 www.commcareinc.org 9
Perhaps you have never imagined that you would need to enlist a home health care provider to assist you in caring for a loved one. Or maybe you are wondering if now is the right time to seek help. Ask yourself some key questions: Are you feeling pressured to meet your other responsibilities to children, spouse, employer and others while caring for your loved one? Is caregiving interfering with your job responsibilities, perhaps putting a strain on your relationship with your employer? Are you fearful that the stress of caregiving is having a detrimental effect on your health and well-being? Are you regularly unable to enjoy leisure activities and activities that bring you joy and relaxation due to your caregiving responsibilities? Has the person that you are caring for lost mobility or other functions that are making caregiving more difficult for you to handle? Has a change in your physical condition made it difficult to continue to properly care for your loved one? If you answered yes to one or more of these questions, it may be time to research home health care services in your community. 10 www.commcareinc.org 11
Time for help Institutionalized Caregiving vs. Home Health Care In the past, long-term caregiving meant a nursing home or institutionalized care. Now, home health care providers like Community Caregivers provide families with options. In fact, most caregiving needs can be met in the patient s home, in familiar surroundings. Home health care offers: 24-hour care Personal care such as oral hygiene, bathing and daily grooming, mobility, transferring and positioning, assistance with toileting and incontinence care. Nursing case management Meal preparation, with consideration to individual health conditions and limitations Physical therapy* Occupational therapy* Speech therapy* Skilled nursing care* Hospice care * Provided with a doctor s order Of course, in-home care offers the benefit of keeping the patient in familiar surroundings, where they are most comfortable. With a ratio of 1 to 1, there is more time for the home health aide to focus on the individual s needs and other tasks related to maintaining the patient s home and lifestyle. Other services that home care provides include: Light housekeeping services, such as dusting, vacuuming, washing dishes, cleaning bathrooms, changing linens, laundry and ironing Medication reminders Meal planning/grocery ry shopping Respite care Pet care Errands Companionship Lisa Smith, LPN and owner of Community Caregivers, says, What separates this type of care from institutionalized care is that we can accommodate odate the individual s own personal non-medical needs within their familiar surroundings. Sometimes institutionalized care is the only option. Such cases would be: IV Therapy Specialized wound care Surgical recovery Enteral feeding (feeding tube) 12 www.commcareinc.org 13
Time for help How to Identify a Quality Home Health Care Provider Choosing an in-home care provider can be a daunting task. Below are some points to consider when interviewing a prospective home health care provider. Training What type of training do they provide for their home health aides? How much time to do they spend with their home health aides before they assign them to a client? The state of Ohio requires that home health aides receive 60 hours of training. Some providers have more intensive training periods. Community Caregivers has a patented 75-hour Home Health Aide Certification Class that delves deeper into issues that home health aides typically face. We like to expand upon the basic knowledge offered in typical training courses by not only explaining limitations and procedural guidelines to follow, but really providing an understanding of why these are in place, says founder Lisa Smith. Supervision What type of supervision is in place for the home heath aides? Is there a Licensed Practical Nurse (LPN) or Registered Nurse (RN) that they can contact if necessary? Most professional caregiving is delivered by certified home health aides, but some programs offer the additional support of RNs or LPNs. Community Caregivers assigns each patient a nurse case manager who provides health evaluations of each client every 60 days at no extra charge. The nurses assigned to each case also make unannounced pop-in visits as part of their supervisory role. Availability What are the scheduling options? Do they provide 24-hour service? Can they accommodate a change in schedule for emergency situations or planned events such as vacations or work travel? Many in-home caregiving services offer flexible scheduling, so that the home health aide is there to assist the client when they need it and that time may vary for each individual. Some may need split shifts of home health aides one for the morning routine and one for the bedtime routine. Consistency Will a particular home health aide be assigned to your loved one? Is there a low turnover rate in the staffing? Adjusting to a new caregiver can be difficult for both the client and the family. At Community Caregivers, consistency of caregiving is of primary concern. All efforts are made to make sure that each client is served routinely by the same home health aide. This allows the aide and client to build a rapport, get to know each other better and establish trust. We assign our home health aides on a case-by-case basis. Because of our in-depth initial assessment where we learn as much as possible about the potential client, we are able to select a home health aide whose personality will most suit that of the client, says Lisa Smith of Community Caregivers. 14 www.commcareinc.org 15
Time for help Communication Does the caregiving service communicate regularly with the patient s family? Is the family involved with developing the care plan, and updating it, if necessary? Is there someone to call to make schedule changes, or answer questions? Communication is important to Community Caregivers. They offer on-call supervisors, available 24 hours a day, seven days a week, to provide support to their home health aides and to give families a point of contact for communications regarding the client s care, schedule or other needs. In addition, each time the home health aide visits the patient, written documentation is provided to the family for review, in order to keep them informed as to the patient s progress and let them know what their loved one s day was like. Responsible/Reliable Is the home health care provider careful about screening aides before they interact with clients? Are their aides bonded and insured? Does the home health care provider require background checks and fingerprinting for all home health aides? How long has this particular company been serving the community? Reliability is an important characteristic to look for in an home health care provider. 16 www.commcareinc.org Billing Does the service require upfront fees or a contract? Is the billing monthly or every two weeks? Are there flat fees or will fees vary each month based on services rendered? Are payment plans available? Discuss billing processes and procedures up front so that you know what to expect. Again, the purpose of a home health aide is to relieve stress and make things more comfortable for clients and family. Billing procedures should be as straightforward as possible. Perhaps the client will be the one handling ng the payment, rather than the family. If the client is elderly, is the billing easy to read and is the format set up so as to eliminate e confusion? Community Caregivers does not charge upfront fees and there are no contracts required. They also are participants in the PASSPORT Program, of which all Ohioans should be aware, that allows Medicaid funds to be used for home health care. Contact your Area Agency on Aging for more details. Referrals Ask around with friends and family, members of your place of worship or within groups that you participate has anyone experienced a home health care service that they would like to recommend? Or contact the service you are considering and request to speak with someone who currently uses their services. All businesses should be accustomed to referral requests, and should be able to put you in touch with a couple of their current clients, their families or physicians. 17
Time for help Talk to Your Loved One about Home Care Services Approaching your loved one to discuss the option of adding an in-home care service can be difficult. Your suggestion might be met with resistance. What follows are some common concerns and some points of discussion for you and your loved one. Why can t you keep doing it all? Lisa Smith of Community Caregivers feels hiring a home health care provider allows for more quality time between the caregiver and their loved one. It is an opportunity for the relationship to revert back to one of mother/ daughter, husband/wife, or whatever it was before the need for daily caregiving became the focus. I would rather spend time with my parents shopping, eating out or doing the activities that we have always enjoyed together rather than devote the bulk of our time together to daily caregiving activities, says Smith. I don t want a stranger in my home. With a good caregiving service, the home health aide and client can form a new relationship, one that not only provides help with daily activities, but the freedom to continue to enjoy what is important in life. Many people do not realize that home health aides offer companionship, daily interaction and help facilitate other fellowship opportunities for the client. Again, consistency can help alleviate this worry. Community Caregivers assigns one home health aide to each client, and that consistency helps build trust and understanding. It is a comfort both for the client and their family. There is no reason to feel that you need to handle it all yourself. Hiring a home health care service does not mean that you are no longer caring for your loved one, it just means that you have a partner in the caregiving process. Often, a home health care provider can give you more time to devote to the relationship in ways that are more enjoyable and meaningful to you both. I don t want to spend the money. A home health care service can be a way for someone to enjoy as much independence as possible and to avoid institutionalization. Families choose to hire a home health care service because they want their loved one to be able to be well-cared for and in their own comfortable surroundings. Of course there is the cost factor to consider when hiring an in-home caregiving service, but many services offer competitive rates. Ultimately, the benefits of hiring a home health care service can be less stress for all involved. If the home health aide keeps the patient in their familiar surroundings, it provides immense psychological benefits to both the caregiver and the patient. If a home health care service can provide a better quality of life, then the value it brings is immeasurable. 18 www.commcareinc.org 19
Time for help Long Distance Caregiving Our society is a very mobile one. Many people do not live in or near the community they grew up in, and that presents special considerations when there is caregiving involved. Many people ple find themselves traveling on weekends and making phone calls to try and oversee the health and care of a loved one. It is often important for families to keep their loved one in the comfort of their own community, but at the same time, caregiving from such a distance can be very stressful on all parties involved. A good home health care service can allow your loved ones to remain in their home in comfortable, familiar surroundings and ensure that you, the caregiver, is completely involved in their day-to-day care. Community Caregivers provides family members with documentation of every visit and will maintain a dialogue with family members via e-mail or whatever method is most convenient. We let family members know what their loved one s day was like and keep them informed as to how we are meeting the goals outlined in their individual care plan, says s Community Caregivers Lisa Smith. 20 www.commcareinc.org 21
Time for help Take Time for Yourself When you are caring for a loved one and juggling other responsibilities such as work and family, often the only person not being cared for is you. But the repercussions of overwork and unalleviated stress can be detrimental to both you and your loved one. Research has shown that services offering support or respite from caretaking responsibilities can help delay or even prevent institutionalizing a loved one. Taking a break from caregiving responsibilities now and then to enjoy a leisure activity, taking a vacation or just taking a break, can be beneficial to both the caregiver and the patient. With renewed energy, you can give your loved one the benefit of the best care possible. It is of utmost importance that you fit your needs into your schedule. It can be very difficult, but realizing that caring for yourself is just as important as caring for your loved one is the first step it takes away the guilty feelings of taking time for you. Try to get enough sleep, eat well and find the time to exercise. Exercise can relieve stress and improve health at the same time. Stay involved in social, volunteer or whatever activities you enjoy. Having an outlet for your energies is important for your quality of life. Seek help when you need it and don t be afraid to ask. Some find asking for help difficult, but it is not a sign of weakness. Remember if your health and well-being suffer, so will your loved one. 22 www.commcareinc.org 23
Time for help What to Expect on the First Day The first day with your home health care service is the beginning of a partnership in care. Many home health care services begin with an initial assessment. Community Caregivers meets with every prospective client to make a detailed patient assessment. This initial assessment forms the basis for a care plan that will be followed, reviewed and continue to evolve throughout the caring partnership. The family is always encouraged to be involved in this process. Initial Assessment The initial assessment includes a head-to-toe medical evaluation followed by a safety review to address anything in the home environment that might pose a safety issue for the patient. The safety review also helps indicate if any home health equipment is needed to help in the care of the patient. individualized. It is the core of what we do offering personalized care that allows the patient to continue living the life they know, to the best of their ability and with our caring assistance. First Home Visit Community Caregivers has a nurse accompany the selected home health aide to the first home visit. The nurse and aide will review the care plan with the client, who is welcome to add to or adjust the plan. The nurse observes the aide as they assist the client, and then they discuss how they like to plan their day. Then the nurse leaves, allowing the new home health aide and the client to get to know one another. We always follow up in a couple days to see how things are going, says Smith. It is all based on getting the right information upfront, and then tailoring the care plan and selecting the home health aide that fits. Gaining Insight In addition to addressing health concerns and needs, Community Caregivers takes time to talk with the potential patient to learn more about them and their background, to gain insight into what is important to them and what constitutes quality of life for that individual. We talk about what they used to do for a living, and about their interests, says Lisa Smith of Community Caregivers. We discuss what they like and do not like to eat, to assist us in preparing meals that they will enjoy. We talk about what they like to do in their downtime watch television, play cards or visit with friends. All of that information is important as we make a plan that suits their personal interests and needs. I see this as an area where we differ greatly from institutionalized care, says Smith. The activities and meals that we plan are truly 24 www.commcareinc.org 25
Aging and Caregiver Resource Information A list of local and national aging and caregiver resources are listed for your reference: Ohio Department of Aging www.goldenbuckeye.com 1-800-266-4346 PASSPORT information www.goldenbuckeye.com/families/passport.html (Can also call the Ohio Department of Aging. See phone number above.) National Family Caregivers Association www.nfcacares.org 1-800-896-3650 AARP www.aarp.org Eldercare Locator 1-800-677-1116 National Alliance for Caregiving www.caregiving.org Area Agency on Aging 1-800-421-7277 Akron-Canton 1-800-686-7367 Youngstown 1-800-626-7277 Cleveland 26 27