STATE PORT PILOT ARTICLE
Southport, NC April 2007
Author: Joie Mahler, RN CSA, Coastal Companion Care LLC
In-Home Care Choices…
Making a Most Important Decision
Most of us would agree that there is “no place like home”. The word “home” is one of the most emotionally charged words we can speak. Our homes hold our hearts, our possessions, and our memories and give us a sense of belonging, comfort and security. For anyone searching for in-home care for themselves or a loved one, this important place called home may have just become even more central to our identity; for inviting someone to come into your home is a very significant event. The AARP’s recent study reflects our desire to continue living in our own sweet abode; showing us that 90 percent of individuals over the age of 60, desire to continue to live as they age, in their home.
Gradually, or sometimes suddenly, it happens to our loved one or ourselves… that household chores become more challenging, that vision, mental or mobility impairment limit our ability to drive or cook safely. Sometimes falls begin to occur that can lead to serious injuries. And it begins; a nagging fear, that we or our loved one is losing independence. In fact, loss of independence is the biggest fear among seniors, as is leaving their home. So what is the typical senior response? Of course, to carry on; to keep going at home; just now, with a little help. Unfortunately, many times children live away and have their own families and full time jobs. Well meaning loved ones many times have commitments that prevent them from assuming the primary caregiver role. This is when it becomes necessary to plan a new strategy to allow us or our loved one to continue to live at home; a strategy that involves some very important choices.
Typically seniors and their loved ones seek in-home care from two very different avenues; they seek and hire someone privately; a caregiver that they solely obtain themselves without the help of an in-home care company, or they seek help from an in-home senior companion care company. These companies provide activities of daily living assistance to seniors in their homes. Steve Everhardt, CEO of the national network of in-home senior care providers; The Senior’s Choice, states; “Caregivers that are not employed by an in-home care company are usually less expensive, however, the senior and their family assume risk involved in hiring and employing them directly. All factors should be taken into consideration, not just the cost of the care.”
Whichever avenue is decided upon to obtain in-home care, there is no mistaking this choice…it is a very important decision for the senior and their family. There are basic, important questions that should be asked by seniors and their families, whether they choose to obtain a caregiver privately or obtain the assistance of an in-home senior care company to assist them to providing care.
Mr. Everhardt states, “This is not a time to shortcut the investigative process, but to make sure that the background work is done either by the family, if they are hiring the caregiver privately or with the assistance of an in-home care company, chosen by the individual and/or their family.” Whichever avenue the individual and family choose, they need to stay actively involved in their choice of in-home care. All factors should be taken into consideration, not just the cost of the care. “Fully trusting those that care for our seniors is essential to the well-being of each family and the well-being of each individual” and key to a senior safely and happily living in the comfort of their own home”, states Mr. Everhardt. In-home care companies are professionally trained to perform the extensive background work that needs to be successfully completed before a caregiver can be placed in a home with an individual.
Listed below are some extremely important considerations and questions that should be asked by families that are privately obtaining caregivers or the chosen in-home companion care company providing in-home senior care:
- Have criminal and DMV background checks been completed?
- Is the in-home companion care company bonded and insured?
- Does the caregiver or the in-home care companion have liability insurance?
- Has the caregiver ever been convicted of a crime or had a moving violation?
- Have 5 previous client/employment references and 5 personal references been checked and approved?
- What is the caregiver’s experience/background in the area of in-home senior care?
- Is there supervision and ongoing training and support for the caregiver?
- Does the caregiver have any certificates or specialized training?
- Has the caregiver worked with (Alzheimer’s disease, stroke, cancer, etc)?
- What is the emergency protocol?
- How much notice will be given if the caregiver can not work?
If the individual and/or family is obtaining a caregiver without the assistance of an in-home care company the following additional questions should be addressed:
- Who will arrange, coordinate and plan the on-going schedule for the caregiver(s)?
- Who is responsible for a replacement if the caregiver is absent?
- Who will be responsible for withholding payroll taxes, and providing state mandated worker’s compensation coverage?
- Can they arrange their own substitute if they are unable to come to work?
Because of the growing complexities of obtaining, hiring and retaining quality in-home caregivers, more and more individuals and families are seeking the assistance of in-home companion care companies to assist their loved one the opportunity to live as independently as possible in their own home. These companies provide a wide range of services including light housekeeping, meal preparation, laundry, daily recreation activities and exercises, transportation and outings, shopping & errands, medication reminders, other in-home care coordination, monitoring safety and companionship. These one on one services can continue even if it becomes necessary for the senior to leave their home and move into an assisted living or even a nursing facility or hospital. There are certain added benefits to choosing an in-home companion care company, such as:
- Professional screening and supervision with on-going training of caregivers Service is customized for the needs of each client and family.
- Service is customized for the needs of each client and family.
- Extensive hours are available with personalized scheduling
- In-home care company is responsible for all employee payroll, taxes, liability insurance, workers compensation and bonding
- In-home care company is responsible for providing all scheduling, coordination and necessary caregiver replacements.
Everhart says, “This service is more expensive than independent caregivers, however, the right in-home companion care company will provide the most customized, trustworthy, reliable, worry free, in- home service available.”
Most of us in the future will face the need for some extra help at home, for ourselves or a loved one. And the truth remains, most of us will want the comforts and security of our home. Choosing an in-home caregiver that is compassionate, trustworthy and professional is always worth the time, money and effort upfront; because our homes really do hold our hearts.
STATE PORT PILOT ARTICLE 8.16.06
“PROACTIVE HEALTH”
By Joie Mahler, RN Certified senior advisor Coastal Companion Care
When I taught high school, my principle always told our staff and students to “be proactive instead of reactive,” to take action now instead of reacting later. I have never forgotten that advice in all areas of my life, especially in planning toward my future health and wellness and, as a nurse, caring for my patients and clients.
The Federal Interagency Forum on Aging-Related Statistics gives us an indicator of the health and wellness for seniors and a prediction of future care for individuals over the age of 65. The numbers are staggering. Presently, there are about 13 million Americans over the age of 65; by 2050 it is projected that number will climb to over 80 million.
Seniors over the age of 85 are the fastest growing segment of the over-65 population. The Federal Interagency Forum also reports that individuals over 65 are significantly better educated today with an improved economic status, more so than at any time in the past.
So what do those numbers mean for all of us today, whatever our current age may be? The positive meaning of these senior statistics is two-fold – we are living longer, and we do have more education and resources than ever before to seek knowledge on how to live a longer and healthier life.
We must take an active role in being proactive to evaluate, plan and implement our own health and wellness plan and to take a proactive approach to our own care.
How do we proceed in being proactive, and what can we really do to make a difference? For starters, we each must begin now. Not next week, next year or in five years, but now. We need to take a closer look at the three leading causes of death among individuals over the age of 65.
I know that doesn’t sound very positive and upbeat… but it is. When we think about heart disease, the number one cause of death today for individuals over 65 – followed by cancer and stroke – and we examine the contributing causes of these diseases, we can be proactive in a personalized “plan of care” we each need for our own health and wellness.
Secondly, from looking at these top three causes of death and disability and the factors that contribute to these conditions, we can look at controllable and uncontrollable factors in our own lives. Controllable factors are those parts of our lives we do have control over and uncontrollable factors are those things that we don’t have any control over.
An example of an uncontrollable factor might be if we know our parents have or had heart disease. But we can choose not to smoke or exercise regularly. Then choosing not to smoking or exercise are examples of controllable factors.
There are many controllable factors you can implement into your own personalized health and wellness plan. We can’t change our genetic make-up but we can choose to exercise and not smoke to prevent heart disease, cancer and stroke. I would say that is being extremely proactive.
Even if you are being treated for one of these conditions or for another disorder, there is much you can do now and in the future to contribute to your own proactive personal plan of care.
Since we are going to be “proactive” about our own current and future health and well-being, I would suggest keeping your own health and wellness journal. This will give you a chance to see on paper what you probably have already been thinking about (like that exercise program you want to start but…).
Looking at your specific, personalized plan on paper may just give you the encouragement you need to get started.
As you look at the three top causes of death – heart disease, cancer and stroke – and learn about their causes, you will find the controllable factors are closely related for all three. That encourages me to know that not smoking and managing stress in my life, for example, can not only decrease my chance of heart disease, but also lower my risk for cancer and stroke.
All of us have uncontrollable factors such as our age, gender, race and genetics. Even though we cannot change these, think about factors you can control. Your controllable factors may include implementing an exercise program that is fun and approved by your doctor, stopping smoking, eating a low-fat healthy diet, taking active steps to control stress in your life, having regular check ups and taking medications prescribed by your doctor. Try to make each controllable factor as specific as possible; this will help you measure your success.
After looking at your controllable and non-controllable factors, make a step-by-step plan to implement your personalized health and wellness plan of care. If exercise is on your controllable list and you are not currently exercising, write down what you could do to start. Be as detailed as possible. Instead of saying I will walk several times a week, note a specific plan – walk four times a week for at least 30 minutes each day.
For today, your plan may be to just talk with your doctor about an exercise plan that is right for you. If you start with specific small steps you will be more likely to succeed.
Don’t be too hard on yourself. If you fall off the horse, just get right back up and on your way. Praise yourself for what you have done, and don’t dwell on what you should have done.
An older man who was a patient of mine many years ago once told me; “I tell myself, ‘Self; you can do it,’ and I do.” I think you will be surprised. There is a lot you can do for your own wellness. Being proactive and getting started today will make all the difference in your future health and well-being.
Encourage yourself and figure out what is a positive motivator for you. It may be you are thinking about how much more energy you have or how much better you sleep when you follow your exercise plan. Use that motivation to your advantage.
Being proactive and actively involved in your personalized health care can and will make a huge difference in guiding you toward a healthier long life.
Joie Mahler is a registered nurse and certified senior advisor with Coastal Companion Care of Caswell Beach.
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