Choosing a home care agency can be daunting. Here are a few tips to help you make an informed decision. First, it is important to know what kind of care you or your family member requires. Home care can range from light housekeeping to skilled nursing. Here are some categories of care:
- Skilled nursing care or medical care – Injections, medication administration, oxygen, and assistance with medical equipment.
- Rehabilitation – Improve range of motion, increase strength, and assist with improving completion of activities of daily living.
- Hospice – Comfort care and end of life care in collaboration with hospice healthcare professionals.
- Personal care – Bathing, eating, dressing, and transferring.
- Housekeeping and chores – Meal preparation, cleaning dishes, laundry, shopping, and errands.
- Night care – Twenty-four hour care. Attention should be paid to the breakdown of the healthcare professional’s schedule for around the clock care. For example, how long will an employee be awake and how long are they required to rest?
- Transportation – Transportation to and from appointments or transportation to social functions. Consider the owner of the vehicle that will be used and any special equipment that will be required. Speak with your car insurance provider if someone else will be driving your car.
- Companionship – Supervision and social visiting.
Learn a little about the agency that you are considering:
- How long has the agency been in the business?
- Consult the Better Business Bureau for any complaints.
- Find a list of services provided by the agency.
- Are there a minimum number of hours the agency requires the care workers to be booked for?
- Does the agency provide for couple care?
- Must a doctor authorize a client to receive home care?
- Does the company accept insurance?
- Is the client responsible for travel costs for healthcare professionals?
- Are there additional fees?
- How to pay for services?
- When to pay for services?
Employees
- Education level for care workers employed by the company.
- Licensing requirements for employees
- Screening process for employees
- How is someone paired with a healthcare professional?
- What if a client does not get along with healthcare professional?
- What if a healthcare worker calls in sick?
These are a few things to consider when hiring a homecare agency, and is by no means complete. It is crucial to research any home care agency before you hire them.
Note: It is important be aware that the state of Washington requires a Registered Nurse to complete a home visit once every six months for those receiving home care services, even if those services are as limited as laundry services or companionship. This is to make sure the home environment is safe for the care workers as well as the client and provides a method to monitor for abuse.
After hanging up with his mother, Alex, is concerned about his mother assisting her friend Georgia at home. Since Georgia broke her hip, she has been having difficulty bathing by her self. Alex spends some time on the internet doing research to try to find out a little bit about home care. Alex finds a company called Health People that assists with care in the home. This company’s website states they assist with personal care such as bathing, medication reminders, meal preparation, shopping assistance, laundry, and they also assist with getting to and from appointments.
Alex calls Health People to set up an appointment to discuss the details of possibly assisting Georgia at home. Alex thinks that Health People may be useful if he is not able to drive his mother, Rosemary, to the doctor or to assist her with her shopping. Rosemary is doing well at home, but Alex likes the idea of having a back-up-plan to assist his mother as she ages. Rosemary loves living at home in her house, and Alex hopes that he can assist her to stay there.
The next step is for Alex to tell his mother about Health People. He and Rosemary then need to broach the subject with Georgia. Alex feels that it may be beneficial to talk to Georgia with his mother present. Alex is aware that sometimes people do not like strangers in their house, but a new person can offer stimulating and needed companionship.
After leaving Georgia’s house Rosemary has a lot to think about. Georgia has asked Rosemary if she would help her a few times a week as she is having trouble getting into the tub after her hip fracture. Rosemary is worried that she does not have enough strength to safely help Georgia into the tub, but she will help her friend anyway.
Rosemary’s son calls that evening to see how she is doing. Rosemary tells her son that Georgia is home now and she will be going over there to help her. Rosemary’s son does not like the idea of his mother “nursing” someone else and is worried that she will get hurt herself. Rosemary explains that Georgia has no one else to help her. They hang up the phone with the expectation that they will meet at her house on Saturday for lunch and discuss the idea further.
Later that night, while eating her tuna sandwich dinner, Rosemary contemplates her situation. She feels like she has gotten herself in over her head and wonders if she needs help looking after Georgia. Rosemary is not sure what to do.
In the last post of Rosemary’s Diary, Rosemary’s friend Georgia, is using a walker after her hip surgery to help prevent her from falling. When assistive devices are needed for adults who have had surgery or generalized balance difficulties, there are a few things to keep in mind. The Washington State Department of Health has published an information guide for adults over the age of 65. This guide includes basic walker information and tips on choosing and using walkers.
- Walkers are often made of lightweight aluminum and can support 50 percent of your weight.
- Choosing the correct walker of the right height and style is important to prevent falls, and should be done by a physical therapist or physician.
- A physical therapist can also assist with initial training for safe walker use.
- Walkers are most commonly available with two wheels, four wheels, or without wheels.
- Walkers may also have brakes, seats, specialized grips, and baskets.
- Walkers often fold to fit in cars or busses
Tips to use a Walker Safely
- Take small steps
- Keep the walker close to your body
- Wear nonskid slippers, socks, or shoes
- Remove throw rugs and clutter from the floor
- Keep your head up while walking to maximize your balance
- Keep both hands on walker, if you need to carry items attach a basket to the walker
- As you walk, move the walker ahead of you one footstep at a time and make sure walker is firmly balanced before you proceed
How to Get up from a Chair While Using a Walker
- Pull the walker in front of you and slide yourself to the front of the chair
- Make sure the walker is level
- Stand up slowly with both hands gripping the walker.
- When you stand up give yourself some time before you walk to make sure that you have good balance.
- Move the walker forward one step and walk towards it
How to Sit Down in a Chair While Using a Walker
- Use your walker to back up to the chair until your legs touch the back of the chair.
- If your chair has an armrest, use one hand to find the armrest of the chair while leaving one hand on the walker (This step varies based on chair).
- Slowly sit down
- Slide back into chair
There is no replacement for having professional assistance and training with medical equipment. The above is a brief overview and is by no means complete. For more information see your physician or physical therapist.
Once Rosemary and Georgia are inside the foyer of Georgia’s expansive two-story house. Rosemary notices some changes in the house. Georgia has always been a flamboyant collector and exuberant fan of knitting and bead projects. Georgia was always piling up things along the floor in the hallway that she said she ‘would get to later’. The hall has been cleared and Georgia’s many projects have been put away.
Georgia is using a walker after her hip surgery. It appears to Rosemary that Georgia is getting along well with her walker, and seems to be overjoyed to have a visitor. Rosemary informs Georgia that she has bought her some groceries and makes to go out to the car to get them; Georgia states that she will help her pack them in. Rosemary opens the door wide enough for the walker and follows Georgia out to the front step. Georgia thankfully only has one step in front of her house and expertly guides herself down the step with her walker, and makes her way to Rosemary’s station wagon. Rosemary unloads the groceries and is not sure how Georgia is going to carry any groceries while holding on to her walker with both hands. Georgia senses Rosemary’s hesitation and carefully bends over to pick up a grocery bag by the handles. Georgia then places the bag on a little seat situated in the middle of the walker. Rosemary is astonished; she did not notice that the walker had a seat. The two ladies finish bringing in the groceries and they finally get a chance to sit down and talk in the kitchen after Rosemary makes them some tea.
Georgia talks and talks and talks about how nice it is to be home again and how she missed all of her things and how she never had any privacy at the rehabilitation center. She liked all of the opportunities to make friends and be social, but Georgia complains that staff and other inpatients would just walk in her room at all hours of the day. Georgia tells Rosemary that she had a friend from her dancing days clean up all of her projects from her hallway, so she would not fall now that she is using a walker. Georgia tells Rosemary that the physical therapist completed a home assessment before she could come home to make sure that she would be safe. All of her projects were relegated to cardboard filing boxes from the office store and placed in a spare bedroom. Georgia appears sad about this but brightens when she tells Rosemary about a new dance she would like to learn. Georgia reports that she will not be using the walker forever, but just until she can get her strength back. Rosemary asks if there is anything else that she can do for Georgia now that she is home. Georgia sips her tea and after a very brief pause, Georgia explains that she is having trouble getting into the tub by herself and asks Rosemary if she would be willing to come over to help her take a shower a few times a week.
Rosemary’s friend Georgia is coming home today after her stay in a rehabilitation center following a hip fracture. She insisted on taking a taxi home and would not allow Rosemary to pick her up. Rosemary decides she will meet Georgia at her home later in the day to make sure that she is settling in properly. Rosemary will pick up some necessities from the grocery store for Georgia and deliver them to her when she goes to visit. Rosemary is excited to have her friend back at home so they can spend some time together.
Rosemary stops by the grocery store to pick up some items for Georgia. Rosemary knows that Georgia loves fried chicken. Rosemary picks up a whole fried chicken conveniently cut into pieces. Next to the chicken there are biscuits and pre-mashed potatoes, gravy, and many ready to eat foods. Rosemary chooses a selection and then picks up some of the basics such as, milk, bread, butter, and some vegetables. Rosemary travels up and down the isles of the grocery store as a method to illuminate any foods or goods Georgia might need. Rosemary thinks that she will play it safe and buys some dishwasher soap, toothpaste, a toothbrush and toilet paper for Georgia. Rosemary checks out with her large load of groceries and then heads to Georgia’s house to see how she is settling in.
Rosemary leaves the groceries in her car and walks up and knocks on Georgia’s door and waits; she does not hear any movement inside and wonders if Georgia is home yet. She knocks with more gusto one more time to make sure that the knock is heard throughout the house. Rosemary waits. Finally, Rosemary hears some movement inside of the house and Georgia opens the door. Georgia is pushing a walker in front of her. She greets Rosemary warmly and they both go inside.
Rosemary finds using the computer to be quite challenging. Sometimes the email messages she sends reach the desired person and sometimes they do not. She is also having trouble navigating through the computer programs. Rosemary considers signing up for a computer class so that she can catch up and keep up with not only her friend Georgia, but her granddaughters as well. Rosemary does not feel that she can keep calling her son on the phone every time she cannot figure out how to do something with her computer.
Computer Classes for Seniors
Senior adults often feel intimidated by the latest technology that their family seemingly uses without effort. As society becomes more and more connected and reliant on technology, it makes sense that there is more pressure on seniors to become familiar with that technology as well. Computer classes can be very useful for the new computer user.
Classes and education seminars designed to teach seniors how to use computers are becoming easier find. Many local high schools and community colleges often offer computer classes. The volunteer run, non-profit organization, Senior Net ( http://www.seniornet.org ) offers classes and seminars on the fundamentals of computers, word processing, internet navigation, and email use. Senior Net has learning centers in approximately 25 states and online classes are also available. Classes are delivered by senior volunteers dedicated to the mantra of “seniors teaching seniors.” Membership fees of $40 are required along with a small course fee depending on the specific class desired. Some locations even offer free question sessions for members as well as non-members, where seniors receive assistance with computer hardware and software questions. Being able to contact family members through email, viewing photos of family and friends online, and navigating the vast World Wide Web can be a very satisfying accomplishment.
Alex, Rosemary’s son, arrives at Rosemary’s house at 7 am to set up a computer so Rosemary can use the internet to keep in touch with Georgia and her daughter Nicole. Alex tells his mother that this is actually his computer from home and now that she needs a computer, it provided the perfect opportunity to upgrade his home computer to something newer. Rosemary asks her son how old the computer is and Alex tells his mother that it is a year old. She attempts to protest that Alex is giving her a new computer and he cuts her off stating that computers need to be upgraded often. Alex works with computers for a living, so Rosemary thinks that he should know.
Alex sets up the flat screen monitor, the tower computer and keyboard on a flip-out desk; then proceeds to plug everything in. He brought a power bar for his mother as she only has two plugs in her living room. He then sets up another box that provides wifi or wireless internet for his mother. There is a knock at the door and it is the cable man to wire Rosemary’s house for cable internet. Rosemary is not sure that she understands this process, but finds that it seems quite complicated.
Once Alex has finished setting up the computer, he has his mother sit down with him to teach her how to check her email. Rosemary uses the mouse as instructed to awkwardly double click on the picture of the envelope on the screen, she is delighted to see that she already has email. Alex helps his mother open the email message so she can read it and it is from Alex and his daughters welcoming Rosemary to email. Alex and his daughters wrote the email last night so that Rosemary would have some instant gratification when her computer was set up. After what seems like hours, Alex has shown his mother the basic function of the computer. Rosemary feels that she understands the basics of email, but feels a little lost with the rest of the information. Alex states that he can go over it all again once she gets used to things.
That even Rosemary decides that she will do some searching on the internet to look for the news as her son had shown her. Later she decides to check her email again. When she uses the mouse to click on the picture of the envelope that signifies her email program, she manages to inadvertently move the picture of the envelope around the screen a few times before opening it. Rosemary finally manages to open her email and finds it empty.
Several days later, Rosemary receives a call from Georgia who is now at the Pine Cone Creek Rehabilitation Center. Georgia tells Rosemary that she will be staying there for about 2 weeks so she can heal, get back on her feet, and complete her physical therapy for her hip fracture. Georgia reports that her daughter Jillian went home yesterday and she would love to see Rosemary.
Rosemary finds Pine Cone Creek Rehabilitation Center in the phone book and writes down the address and telephone number. Rosemary calls the rehabilitation center to get directions but cannot understand the person who answers the telephone, so she finds an old map that she has not used for years. On the kitchen table Rosemary unfolds the limp map to find the street she is looking for. Once she finds it she circles it with a pen so that she can easily find it while she is driving. Rosemary carefully folds the map so that she is able to just see the circled area. The map is so big it takes up most of the table and she would not be able to see out of the windshield if she leaves it completely open. One second thought, Rosemary feels that she should pack the phonebook too, just in case she loses the piece of paper with Pine Cone Creek’s address on it.
Rosemary packs up some magazines for Georgia to read, her phone book, her map, and gets into her car. Rosemary finds Pine Cone Creek Rehabilitation Center without any difficulty, partly due to the billboard-sized wood sign near the front gate. Rosemary inquires about Georgia at the main desk and she directed to her room. Georgia is not in her room so Rosemary asks a very young looking employee about Georgia’s whereabouts. Rosemary is told that Georgia must be in the group dining room. Rosemary is directed to the dining room and as she is about to enter, there is Georgia using a walker and being directed by another very young attendant, to purposefully place her walker ahead of her before every step. Georgia is so happy to see Rosemary, she is laughing and crying at the same time. Rosemary makes a mental note that Georgia looks very well and happy. Rosemary was worried about Georgia after the conversation she had with Georgia’s daughter Jillian. But her fears are relieved by the cheerful mood Georgia seems to be in. Back in Georgia’s room, Rosemary learns what it has been like to be in a rehabilitation center. Georgia states that she would rather be home, but does not mind the food and the people seem nice. Georgia tells Rosemary that she is enjoying meeting new people here and there is always something fun going on. Georgia does not seem to be upset to be here as she states that she is receiving daily physical therapy to get back on her feet. Georgia tells Rosemary that she expects to be here at least a month, which is two weeks longer than Georgia had originally told her. Georgia tells Rosemary that she is learning to use the computer and her daughter set up an email account for her so that they can keep in touch.
Rosemary sits at home that night after watching the evening news, she thinks about her day, about Georgia, and her own future. Rosemary writes in her Hello Kitty diary from her granddaughters.
Dear diary,
I had a chance to visit Georgia in the rehabilitation center today. I did not tell Georgia about the conversation that I had with her daughter, Jillian. While I was visiting Georgia I was thinking about Jillian’s worries about where her mother should live when she gets out of the rehabilitation center. Her daughter does not want Georgia to live alone at home and was asking me what to do. I don’t know what they should do. On the drive home today I was wondering what if this happens to me? What would I do, what would my son and daughter do? Maybe I should talk to them both. I am healthy now, but what happens if I am not?
The next morning is Saturday and over her solitary coffee and toast, Rosemary thinks about her friend Georgia recovering from a broken hip. Georgia told Rosemary that she has been keeping in touch with her daughter Jillian by email. Rosemary knows that the internet is available, but has not had much of an opportunity to use it. Rosemary imagines that her grandchildren are using the internet when they are clicking on their gadgets. Rosemary calls her son Alex to ask him about the internet. Rosemary asks Alex if he uses the internet and he tells his mother that he uses it for everything. Alex states that he can find the answer for anything on the internet even the menu for a restaurant. Rosemary wants to know what she can use it for. Could she talk to Georgia through the internet during her stay at Pine Cone Creek Rehabilitation Center? Alex tells his mother that she can keep in touch with her daughter and granddaughters as well as Georgia. They can send messages back and forth, share photos, and even trade recipes if they like. Alex seems exceedingly excited about this and is quickly talking to his mother about all the possibilities for her if she has the internet. Rosemary is worried about how much this will cost and how she will learn to use it. Without asking, Alex states that he will be over in the morning with his old computer to get her started. Rosemary is excited to keep in close touch with Georgia and feels that she is one step behind her friend who already knows how to use the internet.
Seniors, Computers, and Email
It comes as no surprise that more and more seniors are using computers to keep in touch with their families. Although it seems that computers are much more simple than they used to be, they can be daunting to a senior who has never used this medium to communicate. Seniors often report that they feel that they will “break” something or may do the wrong thing.
Email can be made much more simple for seniors with software such as Paw Paw Mail and Red Stamp Mail. This software provides an interface with large icons such as “Read Mail”, “Send Mail”, and “Photos” so it is easier for the senior to see what they are looking for. For more information see: pawpawmail.com or redstampmail.com
Remember to research thoroughly before purchasing anything online.
