Tag: best home care Philadelphia

How to know when its time for home care

Give your thanks by showing them you care

 

This day each year, we gather to give thanks for another year. We are seeing some relatives for the first time in a while. At these reunions we usually put our best face forward. This is no exception for older adults.

 

The Positive Approach to CareTM classifies dementia by six gemstones (click here to learn more). The first two are sapphire and diamond. The sapphire symbolizes normal aging and forgetfulness, which is not dementia. The diamond, however, is the first stage of dementia.

 

A diamond is highly functioning and may not be aware of its own cognitive decline. It can cover up forgetfulness and other warning signs for periods of time, such as during your reunion.

 

We should spend extended periods of time with our loved ones to truly understand their needs. Although casual conversation throughout the reunion will not paint a perfect picture, it can help us understand if we should investigate further.

 

As you talk, test their short-term memory. Alzheimer’s disease inhibits our ability to form new memories first. Discuss something new and bring up the same topic a few hours later. See if they remember having this discussion.

 

During conversion, do they appear frustrated or fixated in a train of thought? Are they unable to “shift gears”?

 

Even if your loved one is not experiencing a cognitive decline, they are still a sapphire. How is their mobility, hygiene, and nutritional intake? Would they be happier or healthier if these basic needs are met? How about socialization? Have they been getting out of the house and trying new things?

 

GEM care for dementia or traditional home care can help your loved one operate at their best. Old age or a progressive disease does not need to prevent them from enjoying their time with us. Have questions about how GEM care or traditional home care can best support your loved one?

 

Call us to learn more or to schedule a complementary wellness assessment by a

Registered Nurse and Certified Dementia Practitioner: 610-323-9800.

 

NursePartners is open 24 hours a day, 365 days a week: 610-323-9800

Personalizing care techniques can reduce behavioral and psychological symptoms of dementia

The most effective care begins with forming a connection, which includes meeting clients where they are in the disease process.

The Tailored Activities Program (“TAP”) aims to reduce behavioral and psychological symptoms of dementia (“BPSD”). This is often what we struggle with as family members and caregivers. How do we engage the person with just enough activity to make them feel loved and needed?

Unchecked challenging behaviors can lead to increased healthcare costs, caregiver burden, and care recipient placement into facilities. There the person living with dementia usually faces pharmacological intervention, which may exacerbate these challenging behaviors or worse.

An Australian trial randomized 180 participants living with dementia by placing them into two groups. One group received 8 home care visits using the training from TAP to train the caregiver and engage with the person living with dementia. The control group received three phone calls with the caregiver about basic dementia related materials from a book, and did not involve the care recipient. Follow up continued four and eight months after the home care visits and phone calls.

The trial was done with individuals living at home or with relatives, outside of formal care facilities.

The results of the TAP pilot trial:

The TAP pilot trial showed overall reductions of incidences of challenging behaviors or BPSD. There were also reductions in other specific behavioral categories as defined by the study:

BPSD overall: F(1,41) = 7.58, p = 0.009, Cohen’s d = 0.72,

Shadowing: F(1,4) = 58.9, p = 0.003, Cohen’s d = 3.10, agitation, Wald X2(1) = 6.0, p = 0.014, Cohen’s d = 0.75

Repetitive Questioning: F(1,22) = 5.94, p = 0.023, Cohen’s d = 1.22

Argumentation: Wald X2(1) = 6.6, p = 0.010, Cohen’s d = 0.77 ()

To read more about the study, click here.

In many ways, TAP is like the Positive Physical Approach to Care as pioneered by Teepa Snow. NursePartners has embraced this methodology since the inception of our GEM division in 2015. It builds on the intuitive notion to engage with people living with dementia according to their life experiences and interests. By appealing to their sense of self-worth, we can prevent or mitigate some of the most challenging behaviors.

 

NursePartners trains all carepartners in the GEM methodology as perfected by Teepa Snow.

All carepartners are trained to engage with clients, focusing on what they still can do and letting go of what they cannot. Even at the most advanced stage of dementia, you can find new ways to say hello and make the person feel valued and with purpose.

To learn more about how we can engage your loved one living with Alzheimer’s disease, Frontotemporal dementia, or another form of dementia, call us at 610-323-9800.

Philadelphia dementia care, Philadelphia home care, Philadelphia caregiver

 

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.

dementia care costs, home care costs, fall risk Philadelphia, Alzheimer's Association of Philadelphia, Alzheimer's Association of Delaware River Valley

 

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

 

Angela scheduled to be keynote speaker for “Remembering Those Who Forget”

We are excited to announce that Angela will serve as the keynote speaker for the Presbyterian Older Adult Ministry (POAM) at the event, “Remembering Those Who Forget”.  Angela will talk about her decades of experience working with those living with dementia.  She will be sure to touch upon practical care approaches that can be implemented immediately, in addition to giving her clinical perspective on the disease.  The event is open to those wanting to learn more about Alzheimer’s disease and other forms of dementia.

We would appreciate registration prior to attending the event.  This event is scheduled for next Thursday, May 2, at 8:30am to 1pm in Plymouth Meeting.  Exact details can be found via this link: https://presbyphl.org/events/presby-older-adult-dementia-workhop/

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.

home care Philadelphia, dementia care Philadelphia

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.    

Philadelphia home care, Philadelphia dementia care, Devon home care, Devon dementia care

 

Carepartners work through role play scenarios with dementia coaches and practitioners

NursePartners practices the Positive Physical Approach to CareTM as developed by Teepa Snow and her team.  Each client living with dementia is classified by a GEM stone.  The characteristics of these GEM stones, along with the client’s personality and unique life experiences, dictate our approach.

All carepartners are trained to connect before providing care.  Simply put, we find this the most effective method.  Too often, carepartners push forth their agenda without enough emphasis on how it is affecting the client.  The mentality is to complete the “to do” list as soon as possible.

Unfortunately, older adults are not always moving at our speed.  If they are living with Alzheimer’s disease or another form of dementia, the situation becomes even more complicated.  The older adult may not realize what we are trying to do, even though these actions are intended to assist them.  When we rush to complete tasks, this can lead to unfavorable outcomes.  If we provide care before connecting, this can increase anxiety, depression, or lead to aggression.

All carepartners are trained in the Positive Physical Approach to CareTM methodology.  During orientation, carepartners work with dementia coaches and practitioners as they role play challenging scenarios.  We want carepartners to be prepared for all types of situations.

Carepartners are trained to put their agenda away and go with the flow.  They focus on connecting before rushing to provide care.  This simple investment of time pays dividends in the long run as a meaningful relationship is developed between the carepartner and the client.  The result is that the client becomes more receptive to receiving care.

In this video, Denise encounters a client actor (dementia coach) who is non-verbal and fixated on a task.  Instead of demanding that the client focus on her, she engages him in his task first.  She continues to have a conversation, even though he does not respond to her.

When it is time to perform the caregiving task, Denise is patient as the client stands up.  She respects his independence and does not rush to do everything for him.  Denise helps explain how to get up and helps stabilize his gait during the process.

As he stands, she lightens the mood with movement and rhythm.  Music and rhythm are deeply engrained in our brains and is one of the best ways to connect with someone living with dementia.  Carepartners that employ this preserved skill are more likely to succeed than those who do not.

Would you like to learn more about GEM care services or want to join our team?  Call us today at 610-323-9800.

Click to the link to see the full video:

Denise demonstrates the Positive Physical Approach to Care

 

Philadelphia dementia care, Philadelphia home care, best home care Philadelphia
Denise uses the Positive Physical Approach to Care to guide non-verbal client

Study to evaluate the impact of a cancer fighting drug on slowing neurodegenerative disease progression

This NPR article discusses how Nilotinib seems to work by eliminating toxic proteins that build up in the brains of people with Parkinson’s and Alzheimer’s. The drug seems to activate a mechanism in brain cells that acts like a sort of garbage disposal.  Read the entire article on NRP.

Currently Georgetown University is looking for participants for a randomized, double blind, placebo-controlled study to evaluate the impact of low doses of a cancer fighting drug on slowing the progression of neurodegenerative diseases. Learn more about the study.

NursePartners does not advocate for any specific type of medication.  Our holistic approach seeks to connect before providing care.  For clients with advanced forms of dementia, we explore different ways to say hello and communicate.

Our carepartners follow the Teepa Snow’s positive physical approach to dementia care.  Through extensive training, carepartners learn how to deescalate situations and build meaningful relationships with our clients.  We do not promote a purely medicated method for working with clients living with dementia.