Life-Limiting Illnesses – When to Call Hospice

A life-limiting illness is an incurable chronic disease or condition that no longer respond to curative treatments.

Examples of a life-limiting illness include:

  • Alzheimer’s Disease or Dementia
  • Stroke
  • ALS
  • Parkinson’s Disease
  • Heart Disease
  • Pulmonary Disease
  • Liver Disease
  • End-stage Renal Disease
  • AIDS
  • Cancer

A life limiting illness, coupled with symptoms below, could be indicators of decline and hospice eligibility:

  • Frequent hospitalizations, ER visits, or visits to the physician within the last six months
  • Progressive weight loss (with consideration to weight gain factors such as edema, when applicable)
  • Decreasing appetite
  • Dysphagia or difficulty swallowing
  • Increased weakness or fatigue
  • Decline in cognitive status or functional abilities
  • Increasing assistance needed with Activities of Daily Living (ADLs)
  • Increasing pain or increasing difficulty in controlling pain
  • Increasing dyspnea or shortness of breath
  • Oxygen dependency
  • Reoccurring infections
  • Ascites
  • Increased nausea and/or vomiting that is difficult to control
  • A desire to forgo future hospitalizations
  • A request to discontinue treatment
  • Recurrent or frequent infections
  • Skin breakdown
  • A specific decline in condition

If you or a loved one has a life-limiting illness and are experiencing any of the above symptoms, consider speaking to your physician about hospice services. You can also call At Home Care & Hospice, and one of our team members can help guide you through the process of requesting hospice through your physician.

The Value of Companionship on a Senior’s Mental Health

As a person ages, he or she may begin to lose their ability to live independently due to a variety of physical conditions. These include limited mobility, chronic pain and frailty, as well as typical everyday activities that may become stressors, such as maintaining a household and caring for themselves. Mental health problems may also arise as people grow older. Depression and anxiety are two of the most common mental health conditions.

Health conditions and lifestyle adjustments are inevitable. However, an elderly person does not need to feel alone in dealing with such changes. Whether a loved one needs full-time or part-time in-home care, or just a friendly face to stop in for a visit, in-home care offers a great deal of value that offsets the isolation, depression and anxiety an elderly person sometimes experiences.

Most seniors enjoy the company of family, friends, caretakers and new companions. In-home companionship has a huge impact on the mental health of the elderly. Not only do companionship services provide the senior with much needed interaction, they relieve some of the stress and worry from family caregivers. This allows time spent with family to be more fun and carefree, and less of a stressor.

In-home companionship care includes activities such as:

  • Playing games, telling stories and help with reading
  • Crafts, like scrapbooking and collages
  • Maintaining calendars and organizing social engagements
  • Planning trips outside of the home
  • Assisting with personal tasks
  • Engaging in meaningful conversation

A helpful and friendly companion has a unique influence on a senior’s quality of life. In many cases, after a few visits from a companion, the senior is much more willing to initiate activities and accomplish tasks independently. This sense of self-worth has a significant impact on mental health. For more information on senior companion services, contact AT Home Care today.

Is My Loved One Ready for Home Health Care?

Assisted living, nursing homes and home health care are issues most elderly persons and their loved ones will be faced with at some point. Whether the person struggles with mental disabilities, physical incapacities or chronic illnesses, most times care outside of what family and friends can provide is necessary. When the time comes to think about options, the process of researching and deciding on an approach can be particularly stressful. Some elderly people may be resistant to change, and would prefer to keep present arrangements because they are comfortable and familiar.

Factors to Consider

Home health care is an excellent way to receive specialized medical care in the comfort and familiarity of the patient’s home. However, before determining if this is the right option for you or your loved one, there are several factors to consider.

  • Does the person have an accessible, nearby network of loved ones and friends?This is critical because home health care involves the participation and companionship of those close to the patient. When receiving home health care it’s easy for the person to feel alienated, especially if they live alone, and a familiar support system is very important to a successful in home health care plan.
  • Is the person’s home easily maintained and modified?When an elderly person has medical needs and conditions, it’s important that their living environment is safe. Many times home health care professionals, like nurses and therapists, will recommend some home modifications be made to create a more safe, stable environment for the patient.
  • Is the person comfortable with having unfamiliar faces in their home?This question might seem obvious, but many times it isn’t until a home health aide, nurse or therapist makes their first visit that the patient feels uncomfortable with the arrangement. Make sure you or your loved one understands who is visiting and why. It’s important to work with the home health agency to ensure there is a good match between the medical professional and the patient.

There are many other key points to consider that are unique to each person. Talk to your family and loved one about the available options of care and try to get feedback in all areas. Together you can decide if this is the right time for in home health care.

How In-Home Care Promotes Independence in the Elderly

Independence is an important part of life, but daily human interaction and regular activities are important to a senior’s health and happiness. There is no denying that keeping seniors physically, mentally and socially active can result in overall better health and the ability to live independently longer. Having the right person step in and offer a helping hand is just what most seniors need to achieve their highest level of independence.

A nurse or caregiver can provide an interactive approach to in-home care that stimulates a senior’s natural ability to perform. At a very basic level, in-home caretaking is health care combined with task-oriented activities to encourage a senior’s independence. Overall health and independence is promoted when engaging activities are the focus. There are four main areas of concentration for an interactive approach to in-home care.

  1. Physical Activity
    Once physical activity is approved by a doctor, it’s important to remain as active as possible. Sometimes all it takes is a companion to make being physically active more enjoyable. Dancing, stretching, walking, gardening and housekeeping are all suitable forms of physical activity that will improve one’s physical and emotional well-being.
  2. Socialization
    Being around others is critical to a high quality of life. As people age, life changes occur that sometimes result in feelings of isolation. By meeting up with friends and loved ones outside of the home, or attending parties and other events, a senior may regain confidence. Additionally, research shows that socializing slows the development of memory problems.
  3. Mental Stimulation
    Regularly participating in mind-engaging activities is important for a seniors brain function. Activities such as card games, crossword puzzles, computer activities, arts and crafts and storytelling are all fun and accessible ways to stimulate the brain. These games and activities keep the mind active, and promote healthy mental growth.
  4. Emotional Well-Being
    Feeling connected and involved are significant factors that contribute to emotional health. This can include simple things like staying in touch with family and friends, being involved in the community or learning a new hobby. Unlike those included in the socialization category, these are things the senior can do alone, or with friends and loved ones.

Tips for Finding the Right Home Health Care Agency

An Aging Population And Other Outside Factors Means More People Are Turning To In Home Health Care in Virginia

As the population ages, and hospitals cut back on their stays, more and more people will be looking to home health care as an alternative. Did you know that home care is approximately two-thirds less expensive than hospital or nursing home care? Knowing the options for the continuum of care can help alleviate some of the anxiety that occurs when a loved one leaves the hospital or has increasing medical needs.

The pace and unfamiliar surroundings of a hospital or nursing home can be confusing. Not only is the financial burden of a hospital stay alleviated with home care, studies show that patients with home care often enjoy a faster rate of recovery and the chance of further hospitalization is minimized. The decision to choose a home care giver can seem overwhelming, but the points outlined below should direct you to resources that will make the process much easier. Not only do you want to ensure that the care you will be receiving is of the highest quality, but, also, that the caregiver will respect your lifestyle as well as your home.

Finding Qualified Agencies

Some of the first things to consider when choosing a home health agency are:

  1. Type of care or services that will be needed,
  2. The care giver’s level of training, and
  3. The financial coverage provided by your insurance or Medicare.

You will want an agency licensed by the Center for Medicare/Medicaid. A physician or an Area Office on Aging can help you evaluate your needs and provide you with a list of licensed agencies. In addition, Medicare ranks all the agencies that they certify and conducts performance surveys of each on specific categories of patient care. There are several professional organizations that have established stringent standards to define quality in home care services that go beyond the minimum state and national requirements. Two of the most respected are: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Community Health Accreditation Program (CHAPS). Agencies that have attained one of these certifications are the most respected in the home care industry.

Questions To Ask a Home Health Care Agency

Once you have a list of potential agencies, it is time to ask about specific care services, as well as the personal standards demanded of the clinicians.

  • What type of license does your agency have?
  • How soon after discharge from the hospital will your plan of care begin?
  • What is the evaluation process for developing a care plan for the patient and assigning care givers?
  • Does a nurse or therapist consult the patients’ family and physicians?
  • How frequently will there be feedback and updates regarding the patient’s progress?
  • How detailed is that patient’s course of treatment?
  • How often does the care giver update the family members and doctor?
  • What procedures does this provider have in place to handle emergencies?
  • Are its caregivers available 24 hours a day, seven days a week?

Additional Considerations

    • References should be availableThe area on Aging that covers the Richmond area is Senior Connections
    • Eligibility for MedicareUS citizens, age 65 years or older, who have contributed to Social security, are eligible for Medicare benefits. Medicare will pay for an unlimited number of visits provided the criteria listed below are met on a continuous basis.  Medicaid is for the poorer population and eligibility in Virginia needs to be checked as legislation is currently being altered.
    • Home Health Care Eligibility under Medicare
      1. Must be homebound.  This term means confined primarily to the home as a result of medical reasons.
      2. Intermittent need for temporary nursing care or physical therapy.  Examples of this are when a patient suffers from Congestive Heart Failure after a hospitalization; or the need for physical therapy after a joint replacement.
      3. A physician’s order and plan of care need to be coordinated with your doctor and a home health agency.
  • Private Insurance Usually follows Medicare criteria, although each insurance policy may have different coverage benefits and different co-pay amounts.  Call your insurance company and ask for specific benefits and service.
  • The Types of Services found at Home Care Providers
    • Nurses (Registered Nurses and Licensed Practical Nurses)
    • Certified Nursing Assistants
    • Physical Therapists
    • Home Health Aides
    • Speech Language Pathologists (speech therapists)
    • Occupational Therapists
    • Medical Social Workers
    • Companions (sitters) –Personal Care & Private Duty

    Taking time to ask a few important questions will go a long way in finding the most compatible home health agency.  For a complimentary home health evaluation after discharge from a hospital please call 804 359-3400, and ask for Barbara Wilson, RN Clinical Director for AT Home Care.

Home Health Agency Services

A home health agency is a great resource if you or a loved one is in need of personalized home health care services. Home health agencies are growing in popularity as a great alternative to traditional medical care. These agencies provide the same type of care and services, but medical professionals visit the patient in their own home. For the elderly community, or those that are ailing or disabled, home health care offers great advantages over outpatient care. In home health care provides the comfort, security and convenience most elderly persons desire.

Patients look to home health care for a variety of medical reasons. Some are preparing for, or recovering from surgery. Others need assistance with ADLs. Many people are going through the stages of dementia and need extra help inside and outside of their home. Maybe an elderly person’s loved ones need assistance, or are seeking alternatives for a transition into a nursing home or assisted living facility. All of these needs can easily be met through a home health care agency. Most agencies provide customized care plans to meet you or your loved one’s medical needs through a comprehensive in home approach.

Home Health Agency Services

In home health care services typically include:

  • Personal Home Health CareCertified nursing assistants and home health aides help patients with a number of needs like assistance with ADLs, personal hygiene, light housework, meal preparation, medical condition(s) tracking and record keeping.
  • Skilled NursingRegistered nurse (RN) or licensed practical nurse (LPN) coordinates a health care plan with the patient’s physician and oversees most in home care services. Skilled nursing includes chronic disease management.
  • Therapy and RehabilitationPhysical, speech and occupational therapists focus on core areas of therapy and develop personalized rehabilitation plans for patients. Specialized services also include amputee rehabilitation and orthopedic/joint replacement programs.
  • Medical Social WorkSocial workers are oftentimes the connection between the patient and their family, friends and community. They provide support to the patient, but also serve as a guide for loved ones and friends who are unsure as to how to best offer support and companionship.
  • Hospice CarePalliative hospice care helps patients and their loved ones during the most difficult times. This type of hospice care focuses not on treating the disease, but relieving pain, stress and other symptoms that patients with terminal illnesses often experience.

Home Care Resources in Virginia

As the baby boomer generation grows older, the demand for information regarding senior home health care rapidly increases. There are many care options available to seniors that need specialized medical services. However, sometimes it’s difficult for the person and their family to make the best decision for where to seek medical care when faced with various options and choices. Home health care is a preferred alternative to traditional inpatient care because it allows the family to take regular part in their loved one’s care while acting as a full-time support system. Home senior health care is beneficial to elderly persons struggling with a variety of illness, disabilities and physical limitations. Before making a decision, it’s important to be educated on what home senior care entails.

The Virginia Department for the Aging

The Virginia Department for the Aging (VDA) provides assistance and resources to older Virginians and their families. The organization helps educate seniors and their loved ones on how to live as comfortably and independently as possible as they grow older. The VDA has provided a great deal of resources on home care, how to select a provider, how to handle in-home health care problems and what to expect when receiving home health care.

Benefits of In-Home Therapy and Rehabilitation

Therapy and rehabilitation are a suggested treatment and preventative method for people with a number of medical conditions. A person may be preparing for, or recovering from, surgery, and needs pre and post-operative therapy. They may be dealing with a debilitating disease or disability. Others need assistance because chronic illnesses are affecting their mobility and physical abilities. In whatever circumstance, the burden of traveling to and from a therapy facility can almost be too much to handle. This is why in-home therapies are becoming a popular choice for those that need it most.

Benefits of in-home therapy include:

  • Convenience – There is no coordinating of rides or travel time required. It also isn’t necessary to wait for your appointment.
  • Energy saving – When you are ill, disabled or recovering from surgery, the last thing you want is to spend your energy getting up/down stairs or in/out of the car. In home therapy allows patients to save their energy for other aspects of life.
  • Fully functional – Not only is the therapist teaching the patient new techniques, he or she is doing it in the patient’s home – a completely realistic, practical environment.
  • Encouraging & supportive – The familiarity of the same therapist is comforting to patients, and the partnership formed offers a unique type of support.

In-Home Therapy and Rehabilitation Results

Home-based therapies are physically and emotionally motivating for patients. Most patients note that they are more satisfied with their quality of life when receiving care in the home. Many times, patients who receive in-home therapy versus going to a facility are quicker to regain independence and perform personal and household tasks. Depending on their condition, they may also be less likely to seek admission into long-term care facilities as they age.

DIY Healthcare

Over the years, healthcare has evolved from a facility-based, face-to-face, paper-centric industry to one where patients can track and monitor health conditions electronically in the comfort of their homes. The emergence of home health care has impacted the convenience of aging in place, but technology has played a role as well. Some of these new health care alternatives are referred to as do-it-yourself healthcare.

DIY healthcare is simply defined as a type of self-care. It involves the use of patient-directed technologies that enable a person the ability to manage their health without direct assistance from a doctor. These tools are the foundation for connecting continuum care to the home. Although nothing supersedes contact with a human hand, healthcare leaders and researchers foresee that new tools and devices will eventually be equipped to function similar to a caregiver or doctor. These technologies are truly transforming the way Americans receive care on a daily basis.

So what are these industry-changing technologies?

There are a variety of mobile apps being developed, and they’re getting a warm welcome from patients and physicians alike. These technologies are providing patients with real-time data and access to their medical records, as well as numerous other health and wellness tracking tools. Through an easy to use interface, they can track all components of health including diet, exercise, medications and even vital signs.

Medical devices are an important element to DIY healthcare. From being able to remotely monitor various aspects of a patient’s health to acting as an alert system in case of emergency, devices provide those who age in place peace of mind. Systems can be linked to emergency response teams or to medical providers. There is a great deal of flexibility when it comes to setting up devices to specifically monitor elements of a patient’s health.

Did you know…

…slightly over ½ of all doctors are comfortable with mobile apps and devices that monitor vitals?

…86% of doctors think mobile apps will become a critical component to managing patient’s health information?

…of those patients who use mobile apps, over ½ said the technology has replaced some unnecessary trips to the doctor’s office?

…nearly ½ of all people believe DIY healthcare technologies will change the way they monitor their health over the next several years?

Reducing Caregiver Stress & Burnout

Caregivers bridge a crucial gap between an elder, disabled or home-bound individual and their community. Encompassing all aspects of a person’s life, caregiving includes everything from grocery shopping to doctor’s appointments, bathing to preparing meals and whatever else may fall in between. These duties require time, effort and patience. This can be exceptionally difficult when the caregiver has responsibilities to their own family, friends, profession and social life.

Even with affordable home health care options, most caregivers are family to the loved ones they care for. In fact, nearly 25% of the population cares for an elderly or disabled family member and over ½ have other jobs and responsibilities. This can leave caregivers impatient, run-down and burnt out. Research indicates that caregivers are actually at increased risk for depression and other illnesses, especially if they lack professional resources and/or support from family.

Once signs of stress or burnout are present it’s really no longer a healthy option for anyone involved. Symptoms of stress include irritability, anxiety, difficulty sleeping, feelings of resentment, overreacting to nuisances and exaggerating small scenarios. Signs of burnout are a bit more severe. These include feeling helpless, hopeless, overwhelmed and exhausted. Neglecting your own needs and gaining little satisfaction from caregiving are other signs not to ignore.

Here are some tips to avoiding caregiver stress and burnout:

  • Have the humility to ask for help, and accept assistance when people step forward. Delegate tasks; don’t take control of everything.
  • Give yourself a break. Make time in your schedule for relaxation or leisurely activities. Taking time for yourself will result in more effective, efficient caregiving.
  • Accept caregiving responsibilities as opposed to feeling sad about the situation. Find the silver lining in what it is you’re doing, and realize how it’s making you stronger.
  • Don’t neglect your own health. Keep doctor appointments, eat healthily and exercise regularly. Make sure to get enough sleep as it will greatly improve energy, mood and productivity.

If you are the caregiver to an elderly, disabled or home-bound loved one, it’s likely you realize the significance of balancing caregiving duties with your own personal and family life. This balance is crucial to being a patient and nurturing caregiver, but still having the time and energy for your own life. For caregiver support and resources, contact AT Home Care today.