The 5 Mistakes You Must Avoid When Choosing Senior Care

Transcription

1 The 5 Mistakes You Must Avoid When Choosing Senior Care

2 Mistake #1: Thinking that universal healthcare in Ontario means everything will be taken care of. Unfortunately many people are surprised to find out just how challenging it can be to access some aspects of healthcare in Ontario. The level of care provided at home through government programs is often minimal, and is usually very task specific (for example, 2 one hour visits per week to assist with bathing). The level of care provided through these programs is often not sufficient to allow a frail senior to return safely home. Wait time for a bed in an Extended Care Facility (a Nursing Home ) can be months and there is no guarantee that your preferred facility will be the one that is eventually offered. Failing to accept the first offered bed can result in losing your place on the waiting list. Be aware that you may need to make alternate in-home care arrangements until a bed is available. Emergency room waits can be very lengthy (6 hours and more). Waits can be unpleasant and frustrating, with few, if any accommodations being made for seniors. Communication at all levels within the healthcare system is not nearly as integrated as most people expect. This can mean that coordination and follow up of services, procedures, tests and therapies can be haphazard. This in-turn can have serious health implications for senior clients

3 The solution: Be actively involved. Ask questions. Insist on clarification when needed. Follow up on test results etc. Don t assume, find out. How Eldercare Home Health can help: At Eldercare Home Health Nurses advocate for our clients. We know what should be happening and who should be doing it. Our Nurses have the training and credentials to interact with healthcare teams on a professional level. Our Nurses can often help clients avoid trips to the emergency department by recognizing changes in their health and acting proactively. Mistake #2: Thinking that you can make your parents accept care in their home. Just because your parents need help doesn t mean that they are ready to accept help. Many seniors are not prepared to recognize that things have changed. That what they used to be able to do effortlessly like prepare a cup of tea, or go downstairs to do the laundry, they can no longer do safely on their own. There are personal space and privacy issues. There are family dynamics that people are not prepared to have others know about. There is the stress of having someone, a stranger in the home. These are all real and legitimate reasons why many people are resistant to having caregivers in their homes

4 Families who try to impose caregivers on their parents are often frustrated when they find that their parents refuse to allow the caregiver in to the home. Or allow the caregiver in, but then quickly kick them out for trivial reasons. Some will insist that none of the caregivers who are sent to the home are acceptable. Others will insist that they don t need caregivers; they just need support from the family for grocery shopping, meal preparation, housekeeping etc. The solution: Always be honest. Let your parents know that by having help at home it will be possible for them to be safe in their own home and allow them to continue to be as independent as possible for as long as possible. Tell them that by accepting care it will help put you at ease and allow you to feel that they are safe. Agree that yes, it will take a little getting used to but the alternatives may be less appealing the risk of having a fall or other injury, or having to move to an assisted care facility. How Eldercare Home Health can help: At Eldercare Home Health we often work with clients who have never had care in their homes before. We are aware of the issues and our experienced Registered Nurses can often help clients better understand the advantage of having help and not being at risk

5 How Eldercare Home Health can help (continued): We always schedule care based on each individual clients need. We can work to compliment the care provided by family and government agencies. Many clients have care for portions of the day and on only select days of the week - 4 hours a day, 3 times a week, for example. No long term commitment is required. However, if your parents are completely resistant to having care even after trying it for a short period, service can be cancelled with only one day s notice. Mistake #3: Assuming that all senior care companies are run by healthcare professionals: All senior care companies are not run by healthcare professionals. Many do not even have a single healthcare professional on staff. Some senior care companies are actually franchises. Individual offices are often owned and operated by people with little or no healthcare qualifications or experience. Many companies describe their services as non-medical care. This isn't surprising when you learn the backgrounds of some franchise owners. One company, promoting the opening of yet more franchised offices described a new franchisee as having most recently worked with a well-known international coffee shop. Another franchisee had worked at a call center, and another was described as a Commerce school graduate who specializes in entrepreneurship. Are these really the people you want to entrust with the care of your loved one?

6 While some of the new companies providing senior care services are legitimate and have the credentials to back up their claims of expertise, unfortunately, many do not. Just a few of the reasons why you need to care about having healthcare professionals overseeing the care of your elderly family member: Only a healthcare professional can properly assess the health of a frail senior. On a number of occasions Nurses for Eldercare Home Health conducting an initial assessment have sent prospective clients directly to the Emergency department. Families had not recognized how critical the situation was and how important it was to act immediately. PSW staff are hands-on caregivers who require direction from healthcare professionals when working with the frail elderly. They are not trained to, and are not qualified to deal with medications, changing health conditions, medical issues and the overall health of frail seniors. Nurses from Eldercare Home Health regularly see seniors who are receiving assistance though other agencies who are deteriorating unnecessarily, due to the lack of proper supervision and direction of PSW staff by a healthcare professional. Medications are an important part of many seniors lives yet can also contribute to a variety of significant and potentially life threatening issues including disorientation, falls, and paranoia. Only trained healthcare professionals who are experienced working with seniors and have an up to date knowledge of medications and their effects can act proactively to help manage these potential issues. Eldercare Home Health Nurses have the knowledge and expertise to intervene to help prevent inappropriate medication being prescribed to Clients. The Solution: Hire an experienced senior care provider who offers Registered Nurse supervision and direction of all PSW staff

7 How Eldercare Home Health can help: Eldercare Home Health Inc. is owned and operated by Lisa Wiseman BScN., RN., GNC(C). Lisa is a specialist in providing care to seniors. At Eldercare Home Health all assessments are conducted by Registered Nurses. We assign a Registered Nurse to each and every client. The Registered Nurse visits the client a minimum of once every two weeks The Registered Nurse is responsible for case management, including supervising and directing the PSW (Personal Support Worker) staff who provide the hands-on care. Our Nurses also liaise with other healthcare professionals. Eldercare Home Health provides a Registered Nurse on-call, 24 hours a day, seven days a week. Eldercare Home Health does not charge for the services provided by the Registered Nurses and our rate for PSW care is still competitive with that of regular senior care providers. Mistake #4: Hiring unqualified or inexperienced private caregivers: Some families hire caregivers privately. These caregivers may even be foreign educated Nurses. Unfortunately they very often lack the real world skills and experience necessary to qualify them to work with frail elderly clients

8 Clients and their families may be taken with how caring and nice the person seems, yet they themselves, are not qualified to properly assess the prospective caregivers actual skills and abilities. Families may reassign nannies who had been working with another family member s children. It may seem that seniors need help with many of the same activities that children do bathing, eating and toileting, but their actual care needs are hugely different from those of children. The issues that face seniors range from dealing with chronic illness and diseases such as heart failure and Parkinson s to coping with neurological diseases such as Alzheimer s and mental illnesses such as depression, dementia and delirium. Understanding the impact these and other diseases can have on an individual s quality of life, mobility, and ability are key in helping to ensure that the client is safe, well cared for, and is able to participate in life to the fullest extent possible. Some families choose to hire private caregivers under-the-table, for cash. This is a very ill-advised attempt to save money. The risks with these cash arrangements are real and significant. Aside from being illegal, clients risk theft of personal possessions, abuse, coercion, claims by caregivers who injure themselves on the client s property, and disgruntled caregivers who report on their employer s illegal employment arrangement. The Solution: If hiring a caregiver privately, make sure you set them up legally as an employee, pay government remittances properly and on time, and follow the Employment Standards Act. Review qualifications, become informed about the responsibilities that employees will be carrying out and make sure they know how to safely and competently handle these responsibilities

9 The Solution (continued): Have a Vulnerable Sector Police Reference Check completed. Make employment conditional on a successful outcome. Remember any employee needs proper, ongoing supervision. How Eldercare Home Health can help: At Eldercare Home Health all caregivers are interviewed by Lisa Wiseman, the President of the Company. Lisa is a Registered Nurse, the former President of the Toronto Chapter of the Gerontological Nursing Association and has received her Certification in Gerontological Nursing from the Canadian Nurses Association. Lisa has been hiring Nurses and other caregiver staff for more than 20 years. All staff at Eldercare Home Health are employees of the company. We take care of all Government remittances etc. If a caregiver is sick or needs time off, we schedule and orient appropriate replacement staff. We offer ongoing education to our staff and Eldercare Home Health is bonded and insured. We supervise and direct our staff and visit them regularly during their assignments announced and unannounced

10 Mistake #5: Basing your decision about a care provider on price. There is no doubt about it. Price is always an issue, as it should be. Companies that provide care typically charge from $21 to more than $27 per hour for PSW level care. Many care agencies are generalists and provide care to a full range of clients from new mom s returning home from the hospital with infants to seniors living on their own in the community - and everyone in between. A few companies are focused on providing care to seniors. Fewer still, provide Registered Nurse Supervised care exclusively to seniors. Registered Nurse supervision of caregivers can make a significant difference in the quality of life for frail seniors. See example below: Without Registered Nurse supervision (other services): The part time PSW caregiver does not notice that the client hasn t had much to drink. She observes that the client is confused but assumes that it is just part of being elderly. The caregiver goes home at the end of her shift. That evening, while on her own, the client becomes disoriented and falls, fracturing her hip. A trip to the hospital leads to exposure to a hospital borne infection, and skin breakdown due to infrequent position changes during recovery. The client becomes deconditioned due to inactivity and lack of rehabilitation. Previously relatively independent, the senior in this example becomes heavily reliant on caregiver assistance with the activities of daily living (personal hygiene, dressing and undressing, eating, transferring to and from bed, chair and back, moving around, walking etc.). Caregiver hours go from 8 hours per day to 24 hours per day for the

11 first 3 weeks after returning from hospital, and are then adjusted to 12 hours a day on an ongoing basis. With Registered Nurse supervision (Eldercare Home Health): The part time caregiver reports to the Supervising Nurse that the client has become unusually confused and that her fluid intake is poor. The Registered Nurse, suspecting a urinary tract infection, arranges to collect a urine specimen at the clients home and alerts the family Doctor.who orders a urinalysis.. The urinalysis comes back positive, treatment is started, the client is offered fluids regularly, and her condition is closely monitored, she recovers fully. Caregiver hours remain steady at 8 hours per day. The client did not need to visit the emergency department or the Doctor s office In the first scenario, not only does the senior s quality of life suffer but their need for care actually increases dramatically - which of course affects the overall cost of care. The Solution: Be aware of costs, but also be aware of what services are included. Ask questions and do your homework so that you understand what the senior who requires care actually needs. Recognize that the care needs of seniors can, and often do change. Working with a company that is capable of recognizing and responding to these changing needs can mean that the person who requires care is: Safer Less likely to need to go to the Emergency department

12 The Solution (continued): Less stressed Better cared for Happier How Eldercare Home Health can help: Eldercare Home Health has been providing care to seniors in the GTA since A Registered Nurse identifies the client s needs as part of her initial assessment. Because all care is supervised by a Registered Nurse we can respond to our clients changing needs. Eldercare Home Health has a Registered Nurse on-call 24 hours a day, 7 days a week. The Nurse is available to caregivers, Clients and their families to deal with urgent matters. Eldercare Home Health provides Registered Nurse supervised care to seniors in the community at a cost that is competitive with regular agencies Call Eldercare Home Health today for a free, no-obligation Assessment by a Registered Nurse. Call