Elder Help! Proactive tactics “Just in case”

Elder Help! Proactive tactics “Just in case”

Everything Home and Community Health 

By Dr. Aisha Stone


While Covid 19 tries to rear its ugly head again with Omicron and our healthcare system is on overload, our aging parents and adult caretakers are caught in the middle of the storm. Adult children with aging parents servicing as caregivers are already inundated with the common care management of infirmities, illness, multiple disease and disability management and all the other issues you can think of that does not stop, pause or even slow down. After managing an unexpected hospitalization now they are about to discharge from the hospital/rehab back home demonstrating an obvious and apparent decline in their functionality. Help!

If you are an adult child or caretaker of an aging parent or loved one and you have not experienced this scenario, you will eventually!

How can you be proactive and prepared for this moment?

1.    Do your research ahead of time. Look up home care agencies in your local area, read reviews, contact Medicare for to review their STAR rating. Get suggestions from the primary care physician and word of mouth.

2.    Contact the insurance company ahead of time and find out what home care agencies are within network and what services will they cover. There are times, when agencies will verbally accept your loved one to provide nursing (SN), physical therapy (PT), occupational therapy (OT), speech therapy (ST) and bath aide (HHA) but then authorization/approval is declined because they are out of network or they will not authorize certain requested services. This is typical of non-Medicare insurance companies who have their own criteria they follow. If needed, find out if the insurance covers personal care assistance for hourly caregiving needs. If not get referrals from the discharge planner prior to discharge. If your loved one has a long-term care policy, contact them to submit a claim. That can be a daunting and drawn out process. Also find out what skilled nursing facilities and inpatient rehab centers in your area are preferred providers. Not something you want to have to deal with at the last minute. Be informed ahead of time.

3.    Anticipate what equipment will be needed ahead of time. Decline in functionality usually requires some type of assistive device i.e.  wheelchair, walker, cane, bedside commode, raised toilet seat, incontinent products, lift chair, shower bench/chair etc. for your loved one to be safe at home.

 4.    Ensure your home is ready. Reduce any clutter, clear pathways, have a way to secure pets, research meal, prescription or grocery deliveries.  Rehab at home requires a healing environment and space to effectively participate.

 5.    Be prepared to be involved and learning the home exercise program or nursing care services provided. Many insurance companies do not cover long term home rehab/nursing plans of care. Therapist are to teach and provide home exercise programs (HEP). HEP is designed to be done on the day PT do come to the home and after home health discharge.  Nurses are tasked to teach about condition management and processes, educate on new, changed and current medications, provide a medication reconciliation, educate on medication management and address any immediate issues or concern.  If your loved one has a skilled nursing service need ie complex wound care, then you can expect the nurse to provide the care.

 6.    Clear you calendar. Once they arrive home you will be inundated with not just your loved one’s immediate care but now you have follow-up appointments to arrange and transport to, medication and diet changes necessary to follow, home health staff and services provided in your home, friends who just want to stop by. Involve other family members and friends as much as possible. It takes a village to keep from getting caregiver burn out or fatigue. Do not be shy about delegating task to others.  Be ready and prepared.

 7.    Keep an updated journal or record. Keep a list of current medications with name of medication, dosage and frequency, names, addresses and number of all physicians and specialist, record of surgeries and who performed them and hospitalization (dates), and vaccination dates. You will also need this information if you are submitting a Long-term care claim.

Summary: What do you do when you your loved one is admitted to the hospital and/or rehab and the discharge planner/case manager tells you the doctor would think it would benefit your loved one to have home healthcare. What do they provide and How does this work? and… What home care agency do you go with? Who do you choose? You never had to use home care before at this point. The DC planner provides you with a list of agencies and tell you to pick who you want to provide care (RN, Physical Therapy, Occupational Therapy, Speech Therapy, bath aide) in your home. What do you do? How do I prepare for this ahead of time?

The task list above is a good start. If you can be proactive, do your research, prepare your home, call the insurance company, delegate family and friends to help, and get proper equipment and assistive devices you will be able to minimize a lot of stress.

Hope that help! If you desire any elder care and aging coaching contact me at https://mymentor.life/coaches-frontpage/?coach_id=925 or draishastone@gmail.com. No mental health coaching provided.

Dr. Aisha Stone DNP, BSN, RN

Owner and Life Coach for Elder Care HELP!

Home Health RN case manager

Nurse educator in Higher Learning

All coaching advice above is from personal and professional experience only

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