Home Care “State of the Industry” Address

By , February 2, 2011

As the population ages, with more and more people joining the sandwich generation, we find ourselves entering a new era. A difficult one, perhaps, for some. An age where responsibility reigns, and we find ourselves caught in a tug-of-war for time and attention. A precarious balancing beam of selflessness without losing one’s sense of self. Tricky times, these.

AmeriCare was created to help alleviate these stressful situations, so that clients can receive the care they need from the comfort of their own homes, and family members can revert back to their more natural role of Mother, Father, Son, or Daughter; not Nurse.

This industry is constantly evolving, and we, at AmeriCare, felt like it was time to take a page from Washington and offer our own “State Of The Union” address. To talk about where we are and where we see the industry heading. Surely we cannot cover every pertinent issue in a single article, so our intention is to start a dialogue that will help guide the direction that Home Care takes moving forward, making it more relevant and useful to those who rely on our services. We hope you’ll become part of the conversation.

2010: A Year in Review

Following are just a few of the key observations and insights taken from the previous year:

1. Home Care is on the Rise. Home Care is one of the fastest growing industries in the country despite the worst economy in recent history. That is not to say that clients are spending indiscriminately. Everyone is watching their dollars, so it is up to the Home Care providers to earn clients’ business by delivering service that exceeds expectations.  

AmeriCare has been fortunate to enjoy steady growth during these difficult years, due, in large part, to our emphasis on personalized service. This includes:

• Assessing each individual’s care needs independently and working to find solutions that accommodate every situation.
• Providing a selection of caregivers that best fit a client’s needs, and allowing the client to interview and select the caregiver of his or her choosing.
• Identifying resources and financial aid to help families struggling to afford Home Care.

As the industry continues to grow, it will be sure to attract people looking to take advantage of the upward trend; therefore, clients should be careful when selecting a Home Care provider. Don’t hesitate to ask for:

• Copies of the provider’s business license.
• The extent of its insurance coverage.
• Policies regarding recruiting and background checks.

Exercise caution when considering providers. Make sure you feel that they have your best interests at heart and are equipped to handle your most complicated care needs.

2. Technology is Playing a Part. There is no substitute for compassionate understanding and a genuine smile, but innovations in Home Care technologies are helping to enhance human care and contributing to the comfort and safety of our clients. At AmeriCare, we stay abreast of the most current technologies, such as Life Alert systems, digital medication reminders, and home monitoring services so that we can help our clients make informed decisions for their specific care needs.

3. Content is King. The Internet, with its myriad of portals and social channels, is providing a way for Home Care providers to communicate with current and prospective clients like never before. We are no longer simply service providers; we are content providers as well, offering everything from tips on how to organize a home for someone with Alzheimer’s to sharing inspirational stories to lift a caregiver’s spirits during difficult times.

At AmeriCare, we use our website to deliver useful information. We also foster a community of fans on Facebook and followers on Twitter: username @americare. We hope these outlets work to bring people with similar experiences together and offer tips and inspiration that will help make their lives a bit easier. We’re all in this together and we welcome you to join our virtual family.

2011: A Look Ahead

Many of the observations mentioned above will continue to influence the industry in the coming year, but following are a few specific issues that we see being particularly pertinent in 2011:

1. Avoiding Commoditization. As we’ve already mentioned, the dramatic growth experienced by the Home Care industry will lead to an increase in service providers and a greater degree of commoditization within the industry. This increase in competition will benefit discerning clients seeking higher levels of service and elevate the category-leading companies driven to evolve their service offerings to establish a clear point of difference.

Some of the steps AmeriCare is taking to stay ahead, include:

• An emphasis on personalized service.
• Better caregiver training.
• Increased specialization of care giving skills to cater to specific client needs (dementia vs. muscular dystrophy, etc.).
• Allowing clients to interview and choose their own caregiver.
• No minimum hour requirements.
• On-call caregivers for immediate responsiveness.

As new, lesser-experienced companies enter the industry, it is imperative for established providers to continue evolving and avoid becoming commoditized.

2. Continued Advancements in Technology. As mentioned in the year in review, technology will continue to play an important role in the coming years. While Home Care companies aren’t prepared to become sales reps for product manufacturers, we expect that providers may begin to advocate medical innovations that can improve a client’s comfort and safety. Some providers may decide to include these products as part of their care package.

3. Government Aid. Healthcare reform has been a touchy topic, and will continue to be so in the coming year. Currently, most of the financial aid options for Home Care clients are subject to state regulations. Non-medical care is a growing need for many Americans, and should receive more attention in the coming years. At AmeriCare, we strive to stay current on all financial aid options and to help eligible clients obtain all the aid available to them. Look for non-medical aid to become a bigger issue in the coming years.

Clearly, this is just the tip of the iceberg. The beginning of a conversation. We want to hear your thoughts regarding the state of the industry and where it’s headed. Please post comments here and start new conversation threads in the social-sphere. Together, let’s make the future of Home Care as bright as it can be.

Special thanks for this article goes to Doug Lueder, servicing the Metro Atlanta area. Give him a call if you’re an area resident with Home Care questions or needs.

Tags: Americare home care, Home Care Industry

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Siblings Caring For Elderly Parents

By AmeriCare, December 13, 2010

Families are wondrous entities, aren’t they? No two are alike, yet all share the same essential joys and frustrations. Many of  our most life altering moments will occur within the framework of the family unit. Meeting ones soulmate. Naming a child. The moment we realize and truly appreciate the sacrifices our parents have made for us. The moment we realize it’s our turn to return the favor. And when this time comes, it can test a family’s fortitude, forging fault lines in the form of anger and resentment, threatening to create chasms among caretakers.

Or, it can be a loving and caring experience; one where the family pulls together to collectively provide comfort for a parent during the twilight of their life.

Option two sounds better, doesn’t it? So, how do families maintain their integrity while caring for parents who are no longer self-sufficient? How do siblings decide how to share the responsibilities fairly? How does one resist resentment when the responsibilities aren’t evenly distributed? Well, as each family unit is unlike any other, there is not one universal solution. There are, however, some general guidelines that can help maintain harmony through these challenging times.

The key is to develop the following critical skills: communication, empathy, and, above all else, patience. Here are some tangible tips that will help you apply these essential virtues.

Communication

Clear and open communication is imperative when assigning caretaking responsibilities. In many cases, the older child, or the one living closest to the parent, is often chosen as the primary caretaker. This method can be unfair, however, and cause sibling rivalry and resentment.

Hold a family meeting once its been determined that a parent needs ongoing assistance. Speak with a doctor to get a clear assessment of his or her abilities and limitations, then create a detailed list of the needs that will have to be cared for on a weekly basis. Create a budget as well, if some care needs exceed the parents’ financial means. Then, assign roles. If someone’s job allows for more flexibility than another’s, perhaps they assume more of the hands on responsibilities, such as companionship and cooking, while someone with a more rigid work schedule can provide more of the financial support, like arranging for a lawn service or a house cleaning crew.

If possible, don’t allow yourself to be forced into a role. Accept the role that you feel best equipped to handle and embrace it.

If you feel as though you’ve been stuck with the caretaking responsibilities, and that other members of the family are not contributing their share, voice your concerns. Keep a journal of the day-to-day and week-to-week duties and share it with the other family members on an ongoing basis. This is not to rub their noses in their neglected duties, it is intended to keep them informed and show them ways in which they can pitch in.

Also, don’t feel as though caring for your parents is solely the family’s responsibility. Reach out to friends, members of the community, and spiritual centers. Let people know how they can help. You may be surprised by how willing people are to volunteer their time.

Empathy

Imagine the kind of world we’d live in if everyone practiced more empathy. When times are tough, stop for a moment and put yourself in your parents’ shoes. Imagine that this may be you one day. How would you want to be treated, particularly by your children who you sacrificed so much for? Developing an empathetic attitude will help you act compassionately, and keep a healthy perspective, even when the demands feel like they’re beyond your current capacity.

If you are a family member who is unable to provide much of the hands on support, resist offering advise, and especially avoid criticism towards the primary caregiver. Instead, provide as much encouragement and emotional support as you can. If you feel like things could or should be handled differently, offer to help out in that area, don’t just give advice from afar.

Patience

This may sound paradoxical, but you should first apply patience towards yourself, not your parents. You’ve never done this before. You’re not always going to know what to do. You’re going to get frustrated. You’re going to feel overwhelmed. You’re going to wish your life would return to “normal.” These are all natural feelings. Don’t feel guilty about having them. Don’t feel selfish. Be patient with yourself, and understand that you’re not superhuman; there’s only so much you can do. Just do your best.

Be patient with other family members. This is new to them as well. They may be struggling with different emotions than you. They may need encouragement to get involved. They may need support; counseling. Be patient with resistant siblings, or other family members, as you work to integrate them into the program.

Finally, practice patience building techniques, you’ll need them. Breathing exercises, meditation, calisthenics; you may not feel like you have time for such activities, but they will save your sanity in the long run. So, make time.

Caregiving is one of the most challenging roles anyone can assume. And it’s not for everyone. Often family dynamics, personal relationships, individual personalities or present situations do not allow for caregiving to occur within the family. That’s what AmeriCare for. The last thing you should do is allow for a caregiving role to put a strain on a loving family relationship or begin to erode fond memories.

Give us a call if you are interested in learning more about our caregiving services.

We know what you’re going through and are always eager to help.

Tags: Americare home care, elderly parents, family caregiving

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Putting Home Care in Norcross GA in Perspective

By , February 7, 2010

The Evolution of Home Care
In the first century of our country’s history there was no such thing as nursing homes or assisted living. Society was mostly rural and people lived in their own homes. Families cared for their loved ones at home till death took them. In the latter part of the 1800’s because of an increasingly urban society, many urban families were often unable to care for loved ones because of lack of space or because all family members including children were employed six days a week for 12 hours a day. During this period many unfortunate people needing care were housed in County poor houses or in facilities for the mentally ill. Conditions were deplorable. In the early 1900’s home visiting nurses started reversing this trend of institutionalizing and allowed many care recipients to remain in their homes. Nursing homes or so-called rest homes were also being built with public donations or government funds. With the advent of Social Security in 1936, a nursing home per diem stipend was included in the Social Security retirement income and this government subsidy spurred the construction of nursing homes all across the country.

By the end of the 1950s it was apparent that Social Security beneficiaries were living longer and that the nursing home subsidy could eventually bankrupt Social Security. But in order to protect the thousands and thousands of existing nursing homes Congress had to find a way to provide a subsidy but remove it as an entitlement under Social Security. In 1965 Medicare and Medicaid were created through an amendment to the Social Security Act. Under Medicare, nursing homes were only reimbursed on behalf of Social Security beneficiaries for short-term rehabilitation. Under Medicaid, nursing homes were reimbursed for impoverished disabled Americans and impoverished aged Americans over the age of 65. It has never been the intent of Congress to pay for nursing home care for all Americans. The nursing home entitlement for all aged Americans was now gone.

Over the last 40 years, there has been a gradual change away from the use of nursing homes for long-term care towards the use of home care and community living arrangements that also provide in-house care.

With Proper Planning People Could Remain in Their Homes for the Rest of Their Lives
We are seeing a trend towards working conditions like those in urban America in the early 1900’s where both husband and wife are working and putting in longer hours. We are also seeing a return of the trend in the early part of the 20th century where outside visitor caregivers are becoming available to replace working caregiver’s and allow the elderly to receive long-term care in their homes. In addition there is a significant trend in the past few years for Medicaid and Medicare to pay for long-term care in the home instead of in nursing homes.

Given enough money for paid providers or government funding for the same, a person would never have to leave his home to receive long-term care. All services could be received in the home. Adequate long-term care planning or having substantial income can allow this to happen.

We only need to look at wealthy celebrities to recognize this fact. Christopher Reeve, the movie star, was totally disabled but he had enough money to buy care services and remain in his home. President Ronald Reagan suffered from Alzheimer’s for many years but received care at his California ranch. He was also wealthy enough to pay for care when needed. Or what about Annette Funicello or Richard Pryor? Income from their movie careers allowed them to receive care with their multiple sclerosis at home. We will be willing to bet that Mohammed Ali, who is severely disabled with Parkinson’s disease, will probably never see the inside of a care facility, unless he chooses to go there to die. With the proper planning and the money it provides, most of us could remain in our homes to receive long-term care and we would never have to go to an institution or a hospital.

The Popularity of Home Care
Most of those receiving long-term care and most caregivers prefer a home environment. Out of an estimated 8 million older Americans receiving care, about 5.4 million or 67% are in their own home or the home of a family member or friend. Most older people prefer their home over the unfamiliar proposition of living in a care facility. Family or friends attempt to accommodate the wishes of loved ones even though caregiving needs might warrant a different environment. Those needing care feel comfortable and secure in familiar surroundings and a home is usually the best setting for that support.

Often the decision to stay in the home is dictated by funds available. It is much cheaper for a wife to care for her husband at home than to pay out $2,000 to $4,000 a month for care in a facility. Likewise, it’s much less costly and more loving for a daughter to have her widowed mother move in to the daughter’s home than to liquidate mom’s assets and put her in a nursing home. Besides, taking care of our parents or spouses is an obligation most of us feel very strongly about.

For many long-term care recipients the home is an ideal environment. These people may be confined to the home but continue to lead active lives engaging in church service, entertaining grandchildren, writing histories, corresponding, pursuing hobbies or doing handwork activities. Their care needs might not be that demanding and might include occasional help with house cleaning and shopping as well as help with getting out of bed, dressing and bathing. Most of the time these people don’t need the supervision of a 24/7 caregiver. There are, however, some care situations that make it difficult to provide long-term care in the home.

Please note from the first graph below that a great amount of home care revolves around providing help with activities of daily living. Note from the second graph below that the average care recipient has need for help with multiple activities of daily living. Finally, it should be noted from the second graph that well over half of home care recipients are cognitively impaired. This typically means they need supervision to make sure they are not a danger to themselves or to others. In many cases, this supervision may be required on a 24-hour basis. (Graphs were derived from the 1999 national caregivers survey, courtesy www.longtermcarelink.net.)

It is precisely the ongoing and escalating need for help with activities of daily living or the need for extended supervision that often makes it impossible for a caregiver to provide help in the home. Either the physical demands for help with activities of daily living or the time demand for supervision can overwhelm an informal caregiver. This untenable situation usually leads to finding another care setting for the loved one. On the other hand if there are funds to hire paid providers to come into the home, there would be no need for finding another care setting.

Problems That May Prevent Home Care from Being an Option
Caregivers face many challenges providing care at home. A wife caring for her husband may risk injury trying to move him or help him bathe or use the toilet. Another situation may be the challenge of keeping constant surveillance on a spouse with advanced dementia. Or a son may live 500 miles from his disabled parents and find himself constantly traveling to and from his home, trying to manage a job and his own family as well taking care of the parents. Some caregivers simply don’t have the time to watch over loved ones and those needing care are sometimes neglected.

The problems with maintaining home care are mainly due to the inadequacies or lack of resources with informal caregivers, but they may also be caused by incompetent formal caregivers. These problems center on five issues:

1.    Inadequate care provided to a loved one

2.    Lack of training for caregivers

3.    Lack of social stimulation for care recipients

4.    Informal caregivers unable to handle the challenge

5.    Depression and physical ailments from caregiver burnout

In order to make sure home care is a feasible option and can be sustained for a period of time, caregivers must recognize these problems, deal with them and correct them. The responsibility for recognizing these problems and solving them is another function of the long-term care planning process and the team of specialists and advisers involved.

Adequate Funding Solves Most Problems Associated with Providing Home Care
None of the problems discussed in this article would be an obstacle if there were enough money to pay for professional services in the home. These services would be used to overcome the problems discussed in the previous section. If someone desires to remain in the home the rest of his or her life, adequate preplanning could provide the solution.

This planning must occur prior to retirement. The most obvious way to provide sufficient funds for home care is to buy a long-term care insurance policy when someone is younger, healthy and able to afford the lower premiums. If insurance is not an option, then money must be put aside early in life to pay for care in the future. The only other option is to be rich.

Unfortunately, very few people address the issue of needing long-term care when they are older. This leads to a lack of planning and in turn leads to few options for elder care when the time comes. Lack of planning means most people do not have the luxury of remaining in their homes and must rely on Medicaid support in a nursing home to finish out the rest of their lives.

If you need more information about caring for your loved one, please visit us at www.americarealliance.com.

Tags: Americare home care, elderly, in-home care

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January 2010 is National Glaucoma Awareness Month, Learn How to Help Aging Family Members Who Have This Disease

By , January 13, 2010

When an aging family member starts to have problems with their vision, many times that loss can be attributed to glaucoma. It’s important for seniors and their family members to understand the causes and treatments for glaucoma so that the affected senior can live independently for as long as possible.

Glaucoma is an eye disease that causes loss of sight by damaging a part of the eye called the optic nerve. This nerve sends information from your eyes to your brain. When glaucoma damages your optic nerve, you begin to lose patches of vision, usually side vision (peripheral vision). Over time, glaucoma may also damage straight ahead (central) vision. You may not notice a loss of side vision until you have lost a great deal of your sight. When checking for glaucoma, eye doctors usually look for damage to the optic nerve and any loss of side vision. They may also check your eye pressure.

Glaucoma is often called “the sneak thief of sight.” That’s because people usually do not notice any signs of the disease until they have already lost significant vision. Once lost, vision can’t be restored.

More than 2.2 million Americans age 40 and older have open angle glaucoma, the most common form of glaucoma. At least half don’t even know they have it.

What are the Different Types of Glaucoma?

There are many types of glaucoma. Often, the cause of high pressure in the eye can help tell the type of glaucoma and the best treatment for it. The most common types include:

Chronic (Open Angle) Glaucoma
This is the most common type. In open angle glaucoma, aqueous fluid drains too slowly and pressure inside the eye builds up. It usually results from aging of the drainage channel, which doesn’t work as well over time. However, younger people can also get this type of glaucoma.

Normal Tension Glaucoma
This is a form of open angle glaucoma not related to high pressure. People with normal tension glaucoma may be unusually sensitive to normal levels of pressure. Reduced blood supply to the optic nerve may also play a role in normal tension glaucoma.

Acute (Angle Closure) Glaucoma
Less than 10 percent of Caucasians or African-Americans have this form, but for those of Asian and Native American descent, the risks are as high as for open angle glaucoma. Hispanics are midway between these groups. It causes a sudden rise in pressure, requiring immediate, emergency medical care. The signs are usually serious and may include blurred vision, severe headaches, eye pain, nausea, vomiting or seeing rainbow-like halos around lights. Occasionally, the condition may be without symptoms; similar to open angle.

Secondary Glaucoma
Another 10 percent of glaucoma cases come from certain diseases and conditions that damage the eye’s drainage system. These include diabetes, leukemia, sickle-cell anemia, some forms of arthritis, cataracts, eye injuries or inflammation of the eye, steroid drug use and growth of unhealthy blood vessels.

Post-Surgical Glaucoma
Some surgeries, such as retinal reattachments, increase the chance of getting glaucoma.

Getting more involved in your treatment
Even if surgery or drugs lower pressure in your eye, it’s still possible to lose vision. Therefore, you and your doctor must carefully monitor the disease.
Since you will be visiting your eye doctor regularly, take time and care in choosing a person who you are comfortable with. Your doctor should understand that your questions and concerns are important. A doctor who is willing to work with you, listen to your concerns and provide the best treatment, plays a large part in your success against glaucoma.

You have to help save your sight
You may need medicines every day for the rest of your life. Find support and encouragement from your family, friends and others. Sometimes it helps to talk to people who have experienced the same thing. It can help you to discuss side effects, share ways to remember your medicines and celebrate getting your glaucoma under control.

Unfortunately, there are a few people whose eyesight will continue to get worse, despite doing all the right things to control their glaucoma. Doctors aren’t sure why this happens, but research in this area continues.

The future holds great promise for treating glaucoma. New medicines are being developed. Other treatments may soon become available. In the meantime, take heart in knowing that you’re doing everything possible to treat your glaucoma successfully. The doctor/patient team approach, support from others and promising scientific discoveries will help you look forward to a bright future.

Questions for your eye doctor

You will have many questions as your doctor diagnoses and treats your glaucoma. It’s helpful to keep a list of these questions, especially if they come to mind in between your eye appointments. Write all your questions down and bring the list with you, then discuss them with your doctor. Here are some questions many people have:

•    What do these medicines do?
•    How much will they cost? Will my insurance help pay for them? (These may be questions for your insurance company, not your doctor.)
•    What are the possible side effects of my medicines?
•    Can I do anything to lower the chance of side effects or reduce the effects?
•    What should I do if I miss a dose?
•    Will I need surgery? What are the benefits and drawbacks of laser surgery? Of glaucoma surgery?
•    What will my vision be like after surgery?
•    How long will recovery take? How will I need to change my usual activities?
•    Will I be able to drive? Go to work?

If you or an aging loved one is suffering from vision loss, get it checked out immediately. AmeriCare home care services can assist seniors with errands, grocery shopping, light housekeeping and more. Let an AmeriCare home care staff member keep you or your loved one safe while being treated for glaucoma or any other vision impairment. Find an AmeriCare office near you by visiting http://americareinfo.com, or call 1-800-610-2029.

Tags: aging loved ones, Americare home care, glaucoma, seniors, vision impaired

Posted in: Americare home care, aging, aging loved ones, elder care, glaucoma, home care, senior care, seniors, vision impaired