The goal of home care is to help people maintain and maximize their independence.
Ideally, it should facilitate a person being able to remain as independent as possible for as long as possible in the setting of their choice – their home.
Clearly, independence can mean different things in different circumstances. To a person recovering from a hip replacement, independence might mean something entirely different from someone living in the early stages of Alzheimer’s. No two situations are exactly the same, and while the degree or nature of independence can vary widely, home care should be an empowering service.
Ms. Betty’s Story
Betty, an active older woman, enjoyed playing Bridge with her friends and frequently held dinner parties in her home. She suffered a stroke, fell and injured her knee. After rehabilitation, Betty was unable to drive and was in no position to prepare for gatherings in her home. Home care services empowered her to continue participating in her favorite activities. In addition to personal care, she found value in other services including transportation and assistance around the home.
Oscar and Vera’s Story
Oscar and Vera had lived in their home for over forty years. They could not imagine living anywhere else. Vera was in the middle stages of Alzheimer’s and Oscar had mobility issues. A home care strategy was tailored that enabled them to continue living in their home. Personal care, meal preparation, housekeeping, transportation, and a host of other services were included in their care. Because of home care, they remained in their home safely and with every need fulfilled until Oscar’s final breath. Though their basic needs would have been addressed in a skilled nursing facility, it is unlikely that this couple would have responded as well to the regimented lifestyle and loss of independence.
Beyond the person being served, home care should also be carefully tailored to empower family and friends of the person being served. Perhaps home care service enables family time to be quality time rather than time spent changing light bulbs and doing grocery shopping. Home care could provide the emotional relief that comes from knowing your parent is being cared for by professional and compassionate caregivers.
Katherine’s family lived out-of-state. Their goal was to move her closer to them. In the months leading to that move, the family was empowered to be worry-free. Medical appointments were scheduled and transportation there and back was provided. Each day, a brief summary was written and emailed to family members. Within a week, her son responded with how thankful he was that he could focus on the impending move, free of anxiety about his mother’s well-being.
Even when the basic needs of your loved one are addressed through home care, the service is not complete until you feel at ease with the arrangements. You’ll recognize when you have received the highest quality home care when you no longer spend sleepless nights worrying about your parent’s care.
Health care providers are better situated to provide the best care when they have, as Paul Harvey used to say, “the rest of the story.” The best home care providers take daily care notes to document care. Doctors and psychologists report that having this documentation from a trained caregiver can be quite valuable.
We noted that Evelyn was showing significant memory issues over several weeks. The nearest adult child was out-of-state. Seeing our care notes, he requested we schedule an appointment with her family doctor. Her regular caregiver accompanied her to the appointment. When the doctor asked about the purpose of the visit, the patient could not remember. Had our caregiver not been there, she could easily have been given a quick look-over and sent home. Instead, the caregiver mentioned the patient’s observed memory issues and the physician ordered a cognitive screening. In a very real sense, home care empowered this physician to fully address the needs of this woman.
We received a call from Rebecca, who was juggling many balls at once. She and her husband both worked full-time and were both engaged in volunteer activity. They had two boys, aged 12 and 14. One played soccer and another was in the Boy Scouts. Both enjoyed the playroom that had grown with them through the years. This was one busy family.
Rebecca was primarily interested in my experience with and thoughts about a few different assisted living facilities. I could tell she’d already made the decision to utilize one of them. I shared my thoughts on two I would recommend and another I could not. I asked how much her mother was involved in the selection and whether they had taken her to visit, and was shocked by Rebecca’s response. She had never asked!
Rebecca assumed that her mother would never entertain the notion of living with her and that it would create such a major upheaval in her family’s life that it just wasn’t worth considering. I offered to meet with the family to provide an in-person review of the facilities she was exploring and to talk a little about some of the families we serve.
Like many of those we serve, Rebecca was eager to arrange a family meeting with everyone present. To Rebecca’s surprise, her mother truly wanted to be invited into her daughter’s home to live. And her sons were the ones to offer their playroom as their grandmother’s bedroom.
As the wheels started turning in all of their minds, I shifted gears to start helping them navigate these waters. The new extended family unit felt fully empowered because they fully controlled every decision.
Rebecca expressed great relief that we were helping her mother and, though she made some adjustments in her activities, she felt like she had re-balanced her life to better reflect her values and beliefs. Because the boys had relinquished their playroom, they wanted to play a role in helping get their grandmother situated with her familiar furniture and decor. We involved everyone and even if tempers flared from time to time, everyone played a vital role.
During the transition period, we recommended an appointment with a respected geriatrician who became the new primary care physician.
In reviewing everyone’s schedule and the various needs for assistance, we agreed on a service schedule that seemed to make everyone’s life easier.
Rebecca’s mother lived with them for almost three years before passing away. There were challenging times when Rebecca would second-guess her decision. However, I recently received a handwritten letter from her saying, “these were the best years of my life and, I think, my mother’s too.” She thanked us for providing the services and supports necessary to make it a reality. Though there was no way she could have known about this book, she thanked us for “empowering my family to do what we didn’t think we could do. During difficult times, the Lord always sends angels to help along the way and that’s what I think of when I think of (your company).”
The goal of home care is empowerment. We believe Dorothy had it right in The Wizard of Oz, “There’s no place like home.” Remaining there can be empowering to the person being served, their family and friends, and the healthcare professionals associated with their care.
Sam Sellers, CAEd, is the owner and President of Home Helpers of Little Rock. A recognized expert in aging issues, Sam is passionate about empowering older adults to remain as independent as possible in the setting of their choice. Questions or comments should be directed to Sam at S.Sellers@HomeHelpersHomeCare.com.
“Only those who will risk going too far can possibly find out how far one can go.”
~ T. S. Elliot