Category: Benefits of Home Care

Debunking common myths about hospice. Why you should seek hospice benefits sooner.

When is the right time for hospice? Many families wait too long to take advantage of this free benefit that complements home care services.
Below we debunk a few of the common misconceptions:

1) Your relative is actively dying. False. Two physicians must determine that your loved one has less than six months to live, if their illness would run its normal course.

2) There are no additional treatments. The client receives palliative care, that considers all aspects of their physical, emotional, and spiritual health. They may continue taking most medications, just cannot seek “extreme remedies”, such as chemotherapy. Currently there is no cure for Alzheimer’s disease or other forms of dementia. Clients in the later stages of dementia, “Ruby” or “Pearl”, are usually eligible for hospice benefits.

3) Hospice is only for the client. The family also receives emotional and spiritual support.

4) All hospice clients die. Clients have “graduated” from hospice if their condition improves.

5) You lose benefits after six months. If clients survive for more than six months, they must seek eligibility again. We have also worked with clients who have used hospice services for many years.

6) You will have to get special medical equipment. Hospice is constantly evaluating the needs of your loved one. Almost anything that is needed can be provided by hospice and paid by Medicare. This is one of the best benefits!

7) Hospice must be provided at home. Although many families would prefer hospice services be given at home, hospice goes anywhere.

8) You must relinquish your other home care services. Hospice works best as a compliment to other support services. There is a maximum amount of hospice services per day, usually around two. Clients eligible for hospice usually also benefit from 24/7 care. Hospice aides and home care certified nursing assistants can work together to care for clients, especially with transferring those unable to get out of bed.

We always recommend that clients explore hospice service options, sooner rather than later. Hospice is a great resource to support the client and their family.

Want to learn more about home care services or hospice options?

Call us today at 610-323-9800.

 

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Make mealtimes easier

The following excerpt is from the Alzheimer’s Association’s article about Food & Eating.  The complete article and webpage can be found here.

During the middle and late stages of Alzheimer’s, distractions, too many choices, and changes in perception, taste and smell can make eating more difficult. The following tips can help:

  • Limit distractions. Serve meals in quiet surroundings, away from the television and other distractions.

  • Keep the table setting simple. Avoid placing items on the table — such as table arrangements or plastic fruit — that might distract or confuse the person. Use only the utensils needed for the meal.

  • Distinguish food from the plate. Changes in visual and spatial abilities may make it tough for someone with dementia to distinguish food from the plate or the plate from the table. It can help to use white plates or bowls with a contrasting color place mat. Avoid patterned dishes, tablecloths and place mats.

  • Check the food temperature. A person with dementia might not be able to tell if something is too hot to eat or drink. Always test the temperature of foods and beverages before serving.

  • Serve only one or two foods at a time. Too many foods at once may be overwhelming. Simplify by serving one dish at a time. For example, mashed potatoes followed by meat.

  • Be flexible to food preferences. Keep long-standing personal preferences in mind when preparing food, and be aware that a person with dementia may suddenly develop new food preferences or reject foods that were liked in the past.

  • Give the person plenty of time to eat. Remind him or her to chew and swallow carefully. Keep in mind that it may take an hour or longer to finish eating.

  • Eat together. Make meals an enjoyable social event so everyone looks forward to the experience. Research suggests that people eat better when they are in the company of others.

  • Keep in mind the person may not remember when or if he or she ate. If the person continues to ask about eating breakfast, consider serving several breakfasts — juice, followed by toast, followed by cereal.

Pride month may be over, but our LGBT sensitivity training continues!

NursePartners offers a LGBT sensitivity training in additional to our base dementia (“GEM”) training.

Why is the LGBT sensitivity training important?

According to SAGE, there are 3,000,000 people in the U.S., aged 55 and older, that openly identify as LGBT. When providing care to this community, there is a distinct set of challenges and way to connect before providing care. It is important that the employees providing the caregiving not only understand basic terminology, but listen and understand needs, said and unsaid.

Based on a SAGE survey of 1,857 LGBT older adults, here are some of our key considerations when caring for those in this community.

  • 40% of LGBT older adults, ages 60 to 75 report that their healthcare providers do not know their sexual orientation.
  • 40% of this same group report that their support networks have shrunk compared to 27% of non-LGBT people.
  • 34% are concerned about “being lonely and growing old alone”, compared to 19% of their non-LGBT counterparts.
  • 34% live alone, compared to 21% of their non-LGBT counterparts.

In Philadelphia, we commit ourselves to LGBT older adults through board membership and activism via the LGBT Elder Initiative of Philadelphia. Many of the SAGE findings have also been reported by the LGBT Elder Initiative here. (The LGBT Elder Initiative also offers great programming… if you were not already aware.)

So, what can a potential client that identifies as LGBT expect from NursePartners before the initiation of services?

  • An in-person assessment by a registered nurse, dementia practitioner, and a SAGE-certified employee. Subsequent LGBT sensitivity training has been done internally.
  • The development of a plan of care that not only outlines physical care needs but paints a picture of that individual’s life up until this point. This allows the care team to find ways to relate to the client before they even meet.
  • Given that the client commits to a regular schedule, they can expect a regular care team with whom they can establish trusting relationships. We take our commitment to HIPAA seriously, and this includes issues particular to LGBT older adults.
  • All carepartners are trained in the Positive Physical Approach to Care, as outlined by dementia care revolutionary, Teepa Snow. Many of these care approaches directly translate to individuals who are not living with dementia. It emphasizes connecting, patience, and “joining the client’s world”.
  • Carepartners working with LGBT older adults will also have received a LGBT sensitivity training provided by us.
  • A continuous relationship with NursePartners admin throughout the entirety of their time with us. We are an open book, with 24/7 effective hours of operation. Yes, we in admin sleep, but never all at the same time!
  • We are locally owned and have been hard at work since 2002. Since then, we have developed a network of providers that have also earned our trust. We are happy to share these resources with you if they are needed.

Want to learn more about NursePartners?  Why not give us a call at 610-323-9800?

Fall Costs for Older Adults in the Philadelphia Metro, Fall Risk Mitigation Techniques

Healthcare Costs Attributed to Falls:

The Pennsylvania Department of Health collects statistics for injuries that result in hospitalizations, per cause, per age group. In 2014, these injuries increased greatly for ages 45 to 64, decreased slightly for those 65 to 74, and increased again greatly for those over 75.

Below are the results for three counties in Pennsylvania: Delaware, Montgomery, and Philadelphia. The numbers are not weighted for total population of each county, but rather represent individual counts.

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The National Council on Aging reported that in 2013, that out of 25 injury categories and 7 age groups, total hospital charges for all injuries and ages was greater than $9,100,000,000. Of this amount, $3,700,000,000 was spent on one injury type for one two age groups. This was for fall injuries for adults aged 65 years and older.

Using numbers from the U.S. census for 2013, the population of these three counties aged 65 years or older is approximately 385,762. In costs are divided evenly among the approximate U.S. population of this same age, 44,701,074.  The total cost of falls for older adults in Delaware, Montgomery, and Philadelphia counties was approximately $31,930,316 in 2013.

9,790 individuals in the Delaware, Montgomery, and Philadelphia counties were reported as having sustained hospitalizations due to a fall.  If we consider national costs consistent, the average hospitalization cost for these local older adults was $3,261.52 per fall.  This figure obscures the true cost. Some of these falls result in death while others lead to chronic and permanent injuries, which require increasing amount of funding for the remainder of that individual’s life.

How can you help prevent falls in older adults?

We do not have to wait around for a fall in order to act. Each of us has a role in mitigating the fall risk of older adults. In the senior’s home, we need to be especially vigilant, because this is where they spend the most time, and usually alone.

These are the concrete steps we can take:

  • Clear floor of clutter.
  • Ensure older adult is wearing nonskid footwear or shoes that fit.
  • If they wear glasses, clean them regularly and ensure use.
  • If the older adult is living with dementia, pay attention to the position of their head. Their line of sight is restricting, so they should be looking down at their path ahead.
  • Complete physical therapy exercises to make gains when possible and reevaluate weaknesses.
  • Keep corridors and bathroom properly lighted.
  • Be available to assistance in case of emergencies.
  • Reorganize closets and kitchen to be easily assessible to older adult.

Most, if not all, of these tasks require a consistent presence in the home to ensure compliance. NursePartners is a privately-owned home care company providing traditional home care and dementia care services. We have been around since 2002, founded and operated by a registered nurse and certified dementia practitioner.

Let us help you help them. Call us to learn about what makes NursePartners the agency of choice for families in the Delaware, Montgomery, and Philadelphia county areas. We also call this area home!

610-323-9800

All sources were referenced today, on June 29, 2019.  The organization names are hyperlinked below.

 

Caring for the Caregiver

Both formal and informal (family) caregivers provide care for older adults.  It is important that carepartners practice self care, in order to continue being effective in their roles regardless of whether they are compensated for caregiving services.

Formal carepartners are better able to establish personal boundaries if they are working set hours at established rates via a reputable company.  Although paid carepartners are connecting and building a relationship with the older adult, there are times that they are able to take care of themselves.

In contrast, family caregivers often find themselves in a caregiving role unexpectedly.  They usually find themselves faced with some of all of these predicaments:

  • The needs of the care recipient are increasing over time.
  • The caregiver had another relationship with the care recipient before the illness.  This often complicates the dynamics of the developing relationship as the care recipient feels embarrassed of their condition and the caregiver becomes stressed.  Communication issues and stress can fuel tension.
  • The caregiver does not necessarily know about the disease progression or have medical training.  They may be in denial of basic facts concerning the care recipient’s condition.
  • The caregiver needs to work at least one other job to support themselves and possibly their families and/or care recipient.
  • The caregiver is giving up opportunities for self development, career advancement, and/or building their own immediate families.  The can cause built up feelings of resentment, inhibiting the quality of care of the older adult.
  • The caregiver needs to navigate internal family dynamics.  Typically children are allocated responsibilities based on geographic proximity or other circumstances.  A child without their own family or job may be the first candidate to move in with mom and dad.  Children usually disagree about the equity of task distribution, leading to feelings that can compromise the level of care provided to the care recipient.
  • The caregiver may be caring for an older adult for the first time.
  • They or members of the care team are in disagreement on the basic facts of the situation, such as the validity of the disease diagnosis.  
  • Informal caregivers are always on call.

Regardless of whether you use formal, informal, or both methods of care, it will take more than one person to care for an older adult, especially someone living with a progressive disease such as Alzheimer’s or another form of dementia.  

One important step is developing relationships with other informal caregivers, through organizations such as ARTZ Philadelphia and the CARES program of the Lutheran Settlement House.

ARTZ Philadelphia organizes a meeting of caregivers on a periodic basis to discuss ongoing challenges.  They also host separate events that are meant to provide bonding opportunities for the caregiver and care recipient.

The CARES program of the Lutheran Settlement House organizes events exclusively for informal caregivers.  The creator of the CARES program, Sarina Issenberg, also provides individual counseling meetings free of charge, outside of the organized events.

It is also important to employ the help of formal caregiving services.  There are numerous advantages for having a home care agency involved.  .  Here at NursePartners, we have been extensive experience caring for older adults exclusively for over 18 years.  Although we care for older adults with a variety of chronic and progressive conditions, we formally incorporated a dementia training module into our business operations in 2015.  All carepartners and management are trained and certified in the Positive Approach to Care methodology.

We welcome the opportunity to tell you more about how we can form a new care team, or supplement one that you have established.  Give us a call at 610-323-9800 to learn more. best home care Philadelphia, dementia care Philadelphia, Alzheimer's disease Philadelphia

 

How do you know it’s time to start home care services?

The holidays are coming!  Sometimes with our own busy lives, time passes between each visit to our parents and other older relatives.  At a certain point, home care services can best support them, regardless of if they live at home or in a community.

When is it time to begin home care services?  It is important to remember that home care services can increase gradually.  NursePartners believes a minimum of three, four-hour assignments per week is the best way to start.  This allows the carepartner team time to establish a relationship with your loved one. All carepartners are trained to connect first.  A developed relationship is crucial for providing optimum care.

NursePartners also supports clients 24/7 in their homes, assisted living communities, and nursing homes.

But how do you know it is time to begin services?  When we notice some of the following signs, it may indicate that it is time to start.  Remember, NursePartners provides a health and wellness assessment at no cost before the initiation of services.

We welcome you to take this 20-question quiz to determine if it is time for home care services.  If you score a 25% or higher, it is probably time to schedule a no cost assessment.  All answers are confidential and will not be used for marketing purposes.

If you are still in doubt, give us a call at 610-323-9800.  All calls are answered by a real member of our administrative team.  We do not close at 5pm or on holidays.  NursePartners is a privately-owned company, founded and operated by a registered nurse and certified dementia practitioner.  We have been serving older adults in the Philadelphia area since 2002.

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Why Care Teams Fail: Avoid these four common mistakes

At NursePartners, we understand that each client is unique.  Each person was crafted by their a history of rich life experiences  If they are living with a progressive disease such as dementia, knowing these stories becomes even more important.  Eventually we will have to be the ones to remind them of their stories.

 

Realistic and transparent goals need to be set from the onset of services.  Our standards are high, but the perfect care team needs time to mature.  NursePartners screens employees based on their personality fit with specific clients.  However, just like most relationships, it takes time for clients to trust carepartners.  The best results are realized after several assignments, not the first one.  This brings us to the first reason why care teams fail:

  • Client does not give the care team enough time to mature

Solution: Exercise patience.  Let us know what we can do better and give your loved one a chance to get used to the carepartner.

 

The communication between members of the care team is also important.  NursePartners works well with other service providers, including life managers, social workers, hospitals, nursing homes, hospice, estate attorneys, and other specialists.  The family members are also part of the care team.  However, too much or too little communication can be detrimental to the level of care being provided.  Every one should be on the same page while they work for the same goal: the best care for the older adult.

  • Poor communication among members of the care team

Solution: Share the same documents, do not reinvent the wheel, and include one another in your correspondence.

 

Various sets of expectations by multiple Power of Attorneys or children can set the stage for disagreement.  Sometimes these conflicting actors may not even agree with the diagnosis and subsequently, how to best care for the client.  It is important to remember, the focus should be on the well-being of the client.

  • Disagreement on the diagnosis and expectations of care

Solution: When you talk to your siblings and family, focus your conversation on how to best support your loved one.  It is about them, not about you.  If you want to rule out other possible diagnoses, consult specialists, but consider the impact it has on the quality of life of the older adult.

 

A stable schedule helps the older adult build a routine and encourages the same carepartner(s) to work with client over the medium and long-term.  When schedules change often, so does the daily routine.  It also has consequences for the care team.  We cannot guarantee that the same carepartners will return to your care team if the schedule is interrupted regularly.

  • Erratic schedule changes

Solution: Make a commitment to choose a realistic schedule that allows your loved one to form a relationship with their carepartners.  This allows the plan of care to be executed successfully.  The minimum amount of service for clients with the least needs is usually three to five days per week, of at least four hours each assignment.    

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The role of depression and diabetes in the development of dementias in older adults

What are the symptoms of depression for older adults?  Does depression increase the risk of developing a dementia?  What is the impact of other chronic conditions such as diabetes?

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We mitigate the risk and continuation of depression. It is important to engage older adults in meaningful activities, not only to fight  depression, but also the development of other more serious conditions.

It is important for us to recognize these signs of depression in our older relatives and friends (“Depression in Older Adults”).   

  • Loose of interest socializing or in hobbies
  • Worries about being a burden, feelings of worthlessness
  • Slowed movement or speech
  • Neglect of personal care such as skipping meals, forgetting meds, neglecting hygiene
  • Lack of motivation and energy
  • Weight loss or general loss of appetite
  • Sadness or feelings of despair
  • Sleep disturbances, issues falling asleep, staying asleep, or beginning to sleep at different times

It is important to incorporate meaningful activities and interactions into the lives of older adults.  NursePartners has two company divisions dedicated to offering individualized companion and care services to older adults living in Philadelphia, Montgomery, Chester, and Delaware counties.  By involving your loved ones in meaningful activities early, you may stave off a development of a dementia, especially if the older adults are already dealing with chronic conditions such as diabetes.

In a population-based study of 2.4 million adults in Denmark, depression and diabetes were independently associated with greater dementia risk.  The combined association of the two disorders had a higher association with the risk of developing a dementia than the aggregate effects of the two dependent variables individually.

Covariates included martial status and its possible effect on depression and general health.

According to the study, “during the first year after depression, the associated hazard of all-cause dementia was elevated by nearly seven-fold”.  Additional periods of depression decreased the risk of developing a dementia in comparison to the first year but left the overall hazard ratio dementia risk rate about twice as high as those without depression (See Figure 1).  

This is a link to the full study, “Impact of Depression and Diabetes on Risk of Dementia In a National Population-Based Cohort”.

Other studies have focused on the singular impact of depression on dementia.  To learn more, consult the authors’ reference list in the study cited above.

 

Early Alzheimer’s disease diagnosis: Building Your Care Team

An early diagnosis of Alzheimer’s disease or another dementia can lead to a range of extreme emotions such as anxiety, depression, anger, or relief.  Although there is no cure for this progressive disease, with enough time the person living with dementia can prepare for the future.  The diagnosed person can establish the details of their own care before they are determined by others.

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        Effective caregiving requires a team and a plan.

If you are a family caregiver, you must also prepare yourself for the future instead of reacting to changes as they occur.  It is not possible for one person to attend to all the emotional and physiological needs of another adult in the face of a progressive and terminal disease.  Often intergenerational lines are blurred, and the caregiver assumes multiple roles.

The person living with dementia will increasingly depend on their caregivers.  If you are the only one, they will depend exclusively on you to make sense of the world as they experience changes to their vision, sight, coordination, and speech.  Their memory will be impaired as tangles and plaques increase, neurological connectivity is disrupted, and brain tissue atrophies and is removed from the body.

Often, we make the comparison between raising a child and caring for an older adult.  However, unlike a child, older adults have collected a lifetime of experiences, even if they are no longer able to communicate them.  These experiences give older adults a sense of pride and expectations for how they are to be treated.  Even if they are unable to articulate their wants, they have established a sense of pride.  Eventually they will depend exclusively on their caregivers for assistance.  This means if you are the only caregiver, they will depend on you for 100% of their needs.  When building a relationship, it is important to incorporate the client into their own plan of care.  This is done easiest earlier in the disease progression.  If you wait too long to incorporate other caregivers into your team, the care recipient may be unwilling to accept care from anyone but you.

Even if the caregiver thinks they are physically able to provide care on their own, this care is ineffective.  Extreme stress inhibits our ability to perform our best.  Family caregivers often suppress their own needs and wants to attend to those of the person living with dementia.  Family caregivers find that they are completing the tasks, but without connecting to the care recipient and making mistakes that often lead to confrontation with the care recipient.

If you find yourself frustrated when providing care, consider evaluating yourself for signs of stress.  Click here to complete the assessment.

Qualified professionals are available to help you with the stresses associated with caregiving.  The Lutheran Settlement House offers a free Caregivers Reducing Stress program that creates an individualized program for you in the comfort of your own home.  This program is available for those living within Philadelphia County.  If interested, please visit their website here.

Have you built an effective care team?  Even if your stress levels are tolerable now, you will eventually need help.  Acting now prevents inadequate care and stress in the future.  It allows us to learn the stories of your loved one in time, so we can incorporate them to effectively connect while providing care.

Let us form part of your care team, call 610-323-9800 or complete this form.

 

NursePartners’ coordinates grocery services for our clients

Grocery shopping is not just a chore, it’s essential.  Older adults are especially susceptible to malnutrition (World Health Organization).  It is important that they receive enough nutrition for their bodies to operate well.  Although they may need less calories than younger people, older adults still need to consume the same nutrients.

This population is at increased risk for malnutrition if they have a few of the following risk factors, as identified by Frank W. Jackson, M.D.,

  • in general poor health
  • poor eating habits
  • sudden and unexpected weight changes
  • taking multiple medications
  • poor dental health, especially dental deterioration
  • economic difficulties, causing the older adult to not spend money for their own nourishment
  • loneliness and lack of social contacts; eating is a social activity
  • cognitive impairments that no longer allow the older adult to care for themselves

Remember that the senses are also changing for older adults.  If a food no longer tastes good, it becomes less desirable.  Try using new seasonings and pepper to revive old favorite foods (Elder One Stop).

It is important not only to buy and consume the groceries, but to discard those that have already expired.  Eating an expired food item puts you at risk for food poisoning.  Common symptoms include diarrhea, vomiting, fever, nausea, and dizziness, among others (Health: One How To).

 

NursePartners coordinates grocery orders for clients.  We want to ensure that they are eating a well-balanced diet, consuming enough calories, and avoiding expired items.  Carepartners record what the client eats for each meal.  They do a weekly inventory all items in the refrigerator and cabinets and gives a report to our Administrative Assistant, Tarika Kirkley.  Tarika purchases the groceries online and coordinates the delivery.  A carepartner will be present to confirm the items received and place them away.

As you involve us in the process, it frees you time to enjoy the older adults in your life doing other activities.  To learn more about this and other services, call 610-323-9800.