Tag: best Philadelphia home care

NursePartners looks for carepartners at local career fair

NursePartners was proud to participate in the career fair hosted by the Philadelphia Regional Library system.  Our two delegates were Lakeya Dula, Senior Recruiter and Dementia Coach, and Nafeesah Mays, Certified Nursing Assistant (“CarePartner”).  Philladelphia dementia care, Philadelphia best home care, Philadelphia dementia careNursePartners is looking for CNAs, LPNs, and RNs who specialize in geriatric care.  We are always growing our team and want dependable CarePartners to work in consistent care teams.  We offer assignments (not “shifts”) in three company divisions: traditional home care, GEM (dementia care), and staffing at our partner facilities.  Carepartners receive the detailed plan of care and report before arriving for a first assignment with a new client.

If you are interested in joining our team, please complete an application online for the desired position: https://www.nursepartners.org/about/employment/

Lakeya Dula executes the entire hiring process, beginning with a screen, personality assessment, interview at the Philadelphia Office, executive huddle, background and drug screen tests, orientation, dementia workshop, and additional dementia training.  She seeks personable and dependable CNAs for all three company divisions.  NursePartners is looking for carepartners that want to make a difference in the lives of older adults.  As an executive team, we proceed with each hire only after asking ourselves: “Would we want this CarePartner to care for an older adult in our family”?  If so, we are confident to place them in the homes of our clients. 

Nafeesah Mays has made an exceptional impression on seven of our clients.  As a CarePartner with more than 16 years of working experience in home care and long-term care and assisted living communities, we are happy to have her as part of the team.   As part of the orientation process, Nafeesah participated in an orientation that included a dementia workshop.  During the workshop, dementia coaches role play difficult scenarios with carepartners to see how they might respond with our clients.  Role plays are filmed and played back to the CarePartner so that they can see themselves from the eyes of the client.  Nafeesah is in the process of completing additional dementia training.

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.

Philadelphia home care, Philadelphia dementia care
        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.

 

Hallucinations in Lewy Bodies and other types of dementia

Below is a video clip from Teepa Snow, explaining how the type of hallucination dictates our response.  This video clip is the basis of this article.

Hallucinations: Visual, Verbal, Tactile

Hallucinations are common for older adults living with dementia, especially Lewy Bodies.  As carepartners, it is our responsibility to address the vision and make the care recipient more comfortable.  In order to do this, we need to understand how the person feels about their hallucination.

  • Does the person living with dementia think they are in their childhood home with their favorite dog?
  • Does the person living with dementia believe other residents are hiding in their bathroom?
  • Is someone stealing something from the client’s room?
  • Is a traumatic childhood experience resurfacing?

Our first task is to answer the following question: Does the hallucination scare our client?

If the hallucination is not scary, ask the person how they feel about the image.  Go over to the area with the older adult and look where they gaze.  Ask questions.  Listen to their responses and formulate new questions based on those answers.  Your goal is to get as many details as possible about the hallucination.

As you delve deeper, the original hallucination will disappear.  Eventually their brain will not be able to match their own verbal responses to the image “seen” by their visual sensory organs.

This is your opportunity to switch the topic.  Engage them in a new activity and move out of the original environment.  Do not mention anything that allows them to circuit back to the hallucination.

 

In order to help, we first must understand how the hallucination makes the older adult feel.  

If the client is visibly scared by the hallucination, our approach needs to be different.

We should not ask them for more information about the image!  Instead, we need to offer them more immediate sensory input.

Those living with dementia have a heightened sensation in the palm of their hands.  They also loose the “skill” capacity in some fingers as all fingers become used for “strength”.  By using the hand-under-hand technique, you protect the care recipient and yourself, while providing reassurance.  You are able to guide their next action by retaining a grasp.

When faced with scary hallucinations, you can apply immediate and repeated pressure to their palms by pumping your palm against theirs.  This sensation feels good and will help to redirect their attention.

You will want to be on the person’s preferred side.  This is also known as their dominant side or the side in which they prefer to write.  This is important because it allows you to draw their view more easily.  The client also pays more attention to data and sound on their dominant side.

Simultaneously, you should show that you are worried!  Ensure your face and words match.  Tell and show them how worried you are about the hallucination.

Follow up with an action plan.  Now that you understand, how will you help?  What will you do to get the object to go away?  Where will the client go to be safe?  Describe your next few action steps to the care recipient.  Continue to use the hand-under-hand approach, pump their palm, and continue to look and sound concerned.

Hallucinations are not preventable for those living with Lewy Bodies dementia.  However, we can work to minimize their occurrences in other forms of dementia.  The typical triggers for hallucinations are an emotional experience from that day or week that causes the client to time travel, emotional distress, infection, and dehydration.  A hallucination may be a sign that something else is wrong physiologically with the client.

 

 

 

 

 

Activities for those living with dementia

During the first week of services, NursePartners puts together an activity box for each of our clients living with dementia.  These give carepartners the tools they need to start building a successful relationship.

Carepartners know to communicate client needs as they arise.  Sometimes by learning more about our clients we can find activities that will best engage them.  Occasionally we bring additional items into the client’s home as we discover new interests.

We recommend keeping the brain actively engaged.  Families are encouraged to interact with the person living with dementia to find new ways to connect “and say hello”.  Jeremy Miller, BSW is a Certified Dementia Specialist who offers recommendations on his website: http://www.engagingdementia.com/engaging-products.

 

It is also recommended to involve clients in their own care.  Clients should feel a sense of responsibility.  Carepartners may accompany them to places such as the grocery store or they could shop for these items online.  Grocery delivery and other similar services are coordinated through our office.

Let us tell you more about how we can help you or a loved one age gracefully in place: 610-323-9800.

Understanding Alzheimer’s and other dementias: Hand Under Hand™ Approach

As dementia progresses, it is vital to appreciate the changes in a person’s ability to be able to connect. One critical element that is often missed when trying to share information is the value of changing our delivery process. Dementia care pioneer Teepa Snow developed the hand-under-hand technique, as a guiding and assisting technique that provides family members and caregivers with an amazing connection. It promotes a physical touch connection that is friendly, comforting, and successful, without being intrusive or overbearing.

 

 

 

The hand-under-hand technique also provides a system of feedback and communication between the a loved one living with dementia, and a caregiver. It uses the much practiced and automatic connection between the eye and hand to form a closed circuit between the person who is struggling to understand words and tasks and the care partner. It provides a comforting and calming human connection using a familiar grasp and proprioceptive (deep pressure) in the palm at the base of the thumb.

This eye-hand connection is one of the very first sensory-motor loops established in infants is used endlessly throughout our lives. By using the palmer surface of the hand, and taking the person through the desire motion or movement, we are communicating with touch and movement, without the need for words.

It’s also important and helpful to position yourself below the eye level of the person with dementia. By lowering yourself to their eye level and by using hand-under-hand, you will be able to accomplish your caregiving goals and form a meaningful connection in the process.

Remember: the purpose is to control the situation, not the person. Dementia care partners are in the process together: always do whatever you can to respect the independence, rights, and dignity of the person with dementia.

The use of hand-under-hand is multi-faceted:

  • It is used when greeting someone to sustain a physical connection, allowing the person to become more comfortable with your presence in their intimate space. It differs from a normal handshake that can be uncomfortable to sustain. By having a hand-under-hand rap, you will be able to tell if the person is enjoying your presence and wants you to allow them more space. If they keep trying to let go you, let go and move back further. They may need a break or may not want you in their intimate space at that moment.
  • It can be used when helping your loved one move around. It provides greater stability and support as well as a feedback loop.
  1. Since the arm is the rudder that guides the ship, by rotating the foreman outward or inward you can direct the walking path.
  2. By tipping the forearm down you can indicate physically the cue to sit down in a seat or on the bed.
  3. By tipping the forearm upward you can help the person stand upright.

When used in combination with a gesture or point, it can help provide directions and reassurance when moving through the environment in the later stages, or when in an unfamiliar setting. Because a family member or caregiver is close to the person, the awareness of balance, coordination, fear, or distress is telegraphed can be responded to in a timely manner.

  • Hand-under-hand is essential during the Amber, Ruby, and Pearl gem stages. It allows you to use their dexterity to operate the tool or utensil while your loved one is still actively participating and moving their body parts toward their body (hand to mouth, hand to chest) as they have done for their entire lives. This automatic loop allows people living with dementia a sense of both control and involvement.

Finally, it provides the care partner or family member a way to get feedback on preferences, understanding, readiness, and willingness to participate. It provides a way to do with, not to do or do for.