Experts say that over 80 percent of seniors take at least one prescription medication every day. Of those seniors, half also frequently use supplements and other over-the-counter meds. With so many seniors taking medications and supplements, it’s no wonder that nearly a quarter of all seniors will experience some kind of drug interaction complication.
Home health providers face a number of challenges when it comes to helping their clients and loved ones keep their medications straight. A number of seniors forget to take their medications, take the wrong dose, or take their medications at the wrong time of day. This can have major negative effects, so helping seniors organize their medications should be a top priority for caregivers.
Tips for Organizing Senior Meds:
- Invest in a medication reminder organizer. Most of these plastic containers contain seven different compartments for organizing medications—one for each day of the week. If you can’t find a container that lets you divide medications by time of day, considering buying a separate unite for morning, noon, and night, or however frequently your senior needs to take medications.
- Make a medication dosage chart. You can create one by hand or use a computer spreadsheet to help keep track of medications and supplements. Make sure you list each medication, the times each should be taken, and the number of pills to take with each dose. Then leave a space next to each dosage time to check off when the medication has been taken.
- Make a medication master list. As the caregiver it can be helpful for you to create a master list of all the medications your client currently takes. Include the name of the medicine, the dosage, the dosing frequency, and the possible side effects on the list. This can be a handy guide for keeping track of interactions and negative side effects when new medications are added to the daily regimen.
- Set a reminder to check prescription labels. By checking the labels frequently, you can make sure that old and expired medications are discarded. You will also be able to notify the pharmacist ahead of time when a prescription needs to be refilled. That way your client won’t have to skip doses while waiting on refills.
- Fill all prescriptions with the same pharmacy. This helps you in a couple of ways. First, it is more convenient to deal with a single pharmacy than to try to remember picking up prescriptions at multiple locations. Second, the pharmacist will have a list of all the medications the patient is currently taking and will be better prepared to catch potentially harmful drug interactions before they happen.
- Remember that supplements can be dangerous too. Many vitamins and other supplements that can be purchased over-the-counter can interact negatively with prescriptions. For instance, St. John’s Wort is known to lower the efficacy of many drugs, and magnesium supplements can be harmful when used with certain cancer drugs.
Just because seniors receive home health care doesn’t mean they can’t travel. Whether you’re helping your elderly loved one plan for a week-long vacation or short weekend jaunt, it’s important to help them prepare for travel. Sometimes problems pop up while on the road. Being prepared for the worst can make your vacation plans go more smoothly.
There are nurses that are ready and willing to travel with families and provide the care needed during those outings. If you have been using a health care agency for some time, you may already have a close relationship with one or a few nurses or aides that come to your home.
When you are on friendly terms with a nurse that comes to your home, you can often make an arrangement with them to come on a vacation. This can be a private arrangement with their rate of pay–hourly or a flat fee. Consider that a private arrangement will not have insurance coverage or any endorsement from an agency. This can complicate an emergency or a situation where the nurse does not uphold her end of a vacation care agreement.
If you are new to home health care, then it will be preferable to speak with your agency to determine what nurse and vacation plan would work for you. Agencies try their best to match qualified nurses that have performed well on other assignments of this nature.
Before bringing a nurse you will need to determine:
- Are guests allowed.
- Can you afford an extra room?
- Will the agency cover the nurse’s room and board?
- Will the nurse share a room with the patient?
- Food costs.
- Transportation. Will the nurse drive, fly, or ride with the family?
If the vacation will be out of the country, you may need to wait longer for the agency to find a nurse with the proper identification needed to travel outside of the U.S. An agency may reimburse the nurse for these items if no nurse has a passport or vaccinations needed for travel abroad. This could delay assigment.
Contact your agency well before your vacation date to avoid delaying your vacation. It could take up to a month to find a nurse and re-arrange schedules.
When planning a trip you should gather pertinent information from your senior’s physician. Compile a medical information folder that contains the following information:
- A complete list of medical issues/health problems and current treatment methods
- A list of medications, dosages, and times they are taken with special instructions such as whether or not a medication should be taken with food
- The names and numbers of each of your physicians, even if they haven’t all written prescriptions for you
Gathering all of this medical information in advance can make it much easier to get through customs checkpoints or get your medications replaced if they are lost or stolen on your trip. Make a copy of the information in the folder and keep one with your luggage and the other one on you at all times. If traveling by air, keep medicines in your carry-on luggage so that you aren’t separated from them during your flight. Always keep your medications in their original pharmacy containers.
Seniors can get help with transportation at the airport or train depot to make sure they arrive at their gate in plenty of time. If you are working with a travel agent, these arrangements can be made easily, giving seniors an opportunity to board first and avoid the hurried rush that comes later when the rest of the passengers board.
Tips for More Enjoyable Traveling:
- When traveling, it’s common to be seated for extended periods. It can be helpful to wear compression stockings on long seated trips. They are helpful for preventing conditions like deep-vein thrombosis and resulting blood clots. If you have questions about compressions stockings, check with your doctor.
- Traveling can expose seniors to germs and infection. Seniors should wash their hands frequently or use a hand sanitizer, particularly after spending time on planes, buses, or trains where people are packed together tightly.
- Traveling to foreign countries presents another set of challenges. Seniors should carefully choose what to eat and drink. You can use the CDC website to look up country-specific water- and food-borne illness risks.
- Dehydration can potentially be a problem for seniors who are traveling, too. Keep bottled water with you for your drive or flight and drink as frequently as you are thirsty.
- For traveling abroad it is imperative that seniors get required vaccinations. Sometimes, vaccinations must be started months in advance of travel, so it’s important to find out what vaccinations are needed for travel in countries you plan to visit.
Keeping these tips in mind, seniors can travel more safely and comfortably and be prepared for any problems that arise.
Every person deserves to be safe in their home. Seniors find there are more safety issues due to lessened mobility, vision, and hearing. There are many products on the market that can improve home safety for seniors living at home with or without a caregiver.
- Heat Regulating Shower-head: Some of these shower-heads attach to your shower like a normal shower-head. The attachment reduces the flow of water if it detects high temperature. When the water is cooled, the flow rate resumes. There are two types – shower-head or in-line (between the pipe and head).
- Medication Timing Watch: Medication is a fact of life for most seniors. Many need to be taken at different times, with food, without food, or multiple times a day. A watch with a programmable timer can help an elderly loved one from missing important medication.
- Carbon Monoxide Detector: Carbon monoxide is a silent but deadly killer that does not discriminate. Young and old alike can be killed by never knowing there is a carbon monoxide threat in their home. It has no odor or taste, but can be detected by a carbon monoxide detector. If you own any appliance that can create carbon monoxide these are invaluable.
- Smoke Detector for the Hearing Impaired: Smoke detectors save thousands of lives every year. They emit a high pitched wail that will wake people if smoke is detected. However, the hearing impaired face a double threat from fire when sleeping because they are unable to hear the typical smoke detector. There are smoke detectors that emit light in bright flashes to notify or wake someone with hearing loss. Some can be wired to lighting to turn the whole room light on and off.
- Grabber/Reacher: A grabber or reacher allows anyone that has trouble lifting their arms high, bending down, or is unable to climb a step to reach an item to ‘grab’ it. The product comes in different lengths and is very popular.
- Handles: Handles are very important for mobility assistance. Handles can be installed in showers, by toilets, by steps and stairs, almost anywhere that balance can be compromised. Handles are helpful for every household, not just seniors.
- Walk-In Tub: Tubs that have doors with rubber seals to keep water in are wonderful for people that have been unable to take a tub bath for fear of falling. The tubs have a built in seat, and a locking, sealed door to hold water while the tub fills. A person enters the tub, locks the door, sits, and turns on the water. Bathing is much safer with a walk-in tub for people who are unable to safely step over the side of a traditional tub.
- Non-Skid Mats: Non-skid mats can be placed anywhere that a slip could happen. In the kitchen, in the bathroom, and by entrances. There are many different styles to choose from, including padded.
- Raised Toilet Seat: Raised toilet seats prevent accidental falls when a disable person loses their balance to reach a typical low toilet. There are different styles from a seat that sits on top of the bowl to a version that sits over the toilet, on legs and with arm-rests.
- Personal Alarm: Personal alarms are important for seniors that live in areas that can be unsafe or if they live alone, but close to neighbors. The alarm has a pull-tab that will cause the alarm to emit a very loud screech. This alerts anyone nearby that someone is in need.
Home health care is an increasingly popular option for seniors who can no longer manage all aspects of their personal care. For some families the best and most affordable option is to have an aging parent or grandparent move in with their children or grandchildren. In this situation, a relative is most often responsible for the daily personal care of the elderly adult.
Making the move can be a big transition for both parties as families are forced to make space for the new family member and seniors are forced to deal with losing some of their independence. Before your family decides to make this move, there are things you should consider first.
If you and your loved one have past difference that could make the transition difficult, they should not be ignored. Ask yourself whether or not the relationship you have is open and honest. If there are unresolved issues, they need to be brought into the open and settled. Otherwise, you may find that living together is nearly impossible.
If everyone is emotionally prepared for the adjustment, the next step is to determine what the guidelines will be for the new living arrangements. Seniors may not be able to access all rooms of the house due to physical limitations? Will this create tension or hard feelings? What if your loved one is unable to join you for meals or prepare her food in the kitchen? Some home modifications may be necessary to make sure everyone feels that their privacy is being respected and that no one is purposely being excluded from family activities.
Tips for Managing the Transition to In-Home Care:
- Be honest with yourself about the changes. Do you have enough room for everyone to live together and still maintain needed privacy and personal space?
- Prepare in advance for home modifications or repairs that will be needed to accommodate your loved one.
- Consider have a professional evaluate your home for risks and safety hazards that could be harmful for seniors.
- What furniture will your loved one be able to keep? Are there special items that your senior will have to part with? Talk these things through before move-in day.
- Is wandering a concern for your elderly loved one? It may be necessary to secure doors and windows to keep your loved one safe, particularly when the rest of the family is asleep.
Home caregiving is a wonderful opportunity allowing families to stay together as long as possible while helping seniors get quality care. However, it is important not to gloss over the potential problems. Each should be dealt with effectively in order for the transition to go smoothly.
If you or your loved one require home health care for the first time, you may not know exactly how much information you need to share with your home health aide, companion care giver, physician or nurse. On the one hand, you will want to provide them with enough information to get the best possible care. On the other hand, you want to do your best to maintain your sense of independence and privacy. Maintaining the right balance can be difficult for some, but it is not impossible.
In general, considering the following dos and don’ts:
Do tell your home health provider about your medical conditions. Most of the time, you will be asked a series of questions about your general health. These questions are an important part of making sure you receive the right care. It will also help ensure you receive care from someone qualified to handle your specific case.
Do be thorough about your health history. Sometimes the smallest details can make a big difference your overall treatment. It can be tedious to go over every little health problem for so many years, but sometimes the things that seem insignificant to you can be red flags for a health care provider.
Do be honest about how you feel. Some people think it is impolite or unnecessary to complain about pain or discomfort. Put those feelings aside and tell your nurse or aide about any reactions, symptoms, or other health issues you have. Your provider cannot help you if they do not know what is wrong.
Do keep a list of family members or friends they can call in an emergency. While most home health providers will collect this kind of information from you before the first day, it is often helpful to keep an information sheet posted somewhere in your home where it is easy to find.
Don’t give out sensitive personal information. It is a bad idea to share personal information like passwords and PIN numbers with people you don’t know. Never give out this information, and make sure that any documents containing this type of information are out of sight of your caregiver.
Don’t talk about valuables or where you keep them. Home caregivers are some of the most professional and caring people you will ever meet. However, it is still in your best interest not to talk about where you keep valuable items like cash, jewelry and other collectibles. Of course, it’s always best to keep valuables in a personal safe or store them in a safe deposit box.
Whether you are considering becoming a home health aide or you are thinking about hiring a home health aide to help you care for a loved one, you need to know more about the job and the specific duties it entails. The following is a list of common duties performed by home health aides:
- Change bandages and clean sores or wounds.
- Run errands and help the client get groceries and other household supplies.
- Go with clients to doctors’ appointments and other appointments outside the home. You may be hired to provide transportation as well as give them personal assistance.
- Help patients with medication management, reminding them to take the right medications at the right time and at the prescribed dosages.
- Home health aides don’t always work with seniors. They are sometimes hired to work with disabled children and adults.
- Give treatments to patients including giving alcohol rubs or and applying topical medications.
- Help patients with mobility. This can include things like getting in and out of chairs, beds, tubs and showers and helping them into wheelchairs and cars.
- Help with common daily living tasks like eating, dressing, and bathing.
- Help with household duties such as laundering clothes, linens, and general housekeeping.
- Provide companionship by talking to clients, reading with clients, and helping them with games and other mentally stimulating tasks.
- Keep medical records regarding a client’s condition and overall progress.
- Record the client’s temperature, pulse, blood pressure, and respiration.
This is not a conclusive list of all the duties performed by home health aides. Each job usually requires some flexibility in order to give clients the specific care needed. A good home health aide possesses the following characteristics
Skills and Training: Home health aides should receive some training before working alone. This may come in the form of a mentorship or job shadow training program or from training at a technical or vocational school. Not all home health aides are skilled medical workers. If you need more advanced health care, it’s a good idea to find a licensed RN or LPN.
Interpersonal Skills: Home health aides need strong interpersonal skills to communicate with their clients. Not only do aides need to be able to get important information from their clients, but they need to be able to give clear and concise instructions when providing hands-on care.
Sensitivity: Home health aides do more than just meet the physical needs of their clients. They must also be emotionally perceptive, providing companionship and support for elderly patients.
Children of elderly parents face tough choices. One of the hardest things that a child will ever do is determine whether or not their parent should live alone. As children we find that it is devastating to watch the people who cared for us become unable to perform their day to day care alone. The once strong hands tremble, the same hands that held us steady while we learned to walk, ride a bike, or swing.
As upsetting as it may be to watch a parent become unsteady, it is even more heartbreaking to receive a phone call from authorities or a local hospital that a loved one has been admitted to an emergency room for an injury. Especially, an injury that could have been prevented by having an in-home nurse or aide. Home care may be preferable to assisted living or a nursing home.
When thinking about an assistance choice, answer these questions:
- Has your parent or loved one become confused lately? Do they repeat the same questions or tell the same things to you repeatedly?
- Are bills behind? If memory loss is a problem, bills can be left unpaid which will result in loss of utilities or even loss of the home.
- Do you notice mood swings in your loved one?
- Have your parent(s) been forgetting to go to appointments?
- Do you notice bruises? Does your parent seem to bump into objects that they would normally avoid?
- Do stairs and chairs seem to give your loved one a problem to get out of or up?
- Normally clean homes are increasingly unclean.
- You may notice that your parent’s hygiene is not the same as before, even a few weeks before starting this assessment. It may be hard for them to get in and out of a shower or tub.
Any or all of these things combined can point to a need for in-home care. Approaching your elderly parents about setting up in-home health care can be stressful on both you and them. Bring up your concerns, address the issues you have noticed, and explain that you are only concerned for their well being. When discussing home health care as an option, be sure to point out that your parent will be able to remain at home. Your parent will also be in control of who goes where in their home, will participate in a care plan development, and will be able to remain home as long as possible by choosing home health care.
There are family caregivers all over the nation. Children that want to provide a loving home for their parent(s), grandchildren worried about the care that a nursing home would provide, and families that trade caregiving time between siblings. Then you find the family caregivers that are providing care from a sense of guilt, as if they owe their loved one something. I was one of the ‘guilt’ caregivers. No matter how you end up in the position of caregiver, guilt becomes an almost daily, hourly emotion.
My mother suffered from diabetes and the complications that come with the disease. The complications would not have been so severe if two things had not fell into place so perfectly:
1. She ignored the diabetes for years. Insulin was a ‘fail-safe’ used only when her blood glucose (blood sugar level) was too high.
2. Her doctors in the last years ignored many of her symptoms and complaints, believing she was a hypochondriac. Truth be known, she was, to an extent.
My mother was a nurse. She worked in nursing homes from 1969 when she gained her nursing license, until 2000, when she had to retire for health reasons. I remember her making me promise to never let her end up in a home. When I worked as a CNA in nursing homes in New York (my mother lived in NC), I couldn’t see why she was so dead set against them. Nursing homes have come so far in the decades since their invention. I did agree to her request, though.
I never believed she would need a nursing home before what we consider ‘old age’. But, in 2007 she gave me a call. She and her husband were thinking about having her move into a nursing home. I could feel my muscles tightening up as I said, “I promised you would not go into a home.” Within two months, my husband had driven the 700 miles to bring my mom and a uHaul full of her belongings back to NY.
It was one of the worst mistakes I’ve ever made.
Maybe that sounds harsh. I loved my mom. But, I believed that my CNA training would see me through the demands of caring for a family member. When you work in a nursing home, it is different…the guilt you feel is dampened by the fact that the residents are not your family. You are taught to work hard not to take the job home with you. When you are caring for a loved one in your home–you are on call 24/7. Your job is there, 24/7/365. There is no sanctuary in your own home from the stress of being a caregiver.
I had three small children at the time, the same time my mother was going downhill physically. She was not a thin woman, I did not have the equipment needed to keep the weight from my back to move her, nor was her condition degraded enough to allow Medicare to fully purchase the equipment. It was hard physically and emotionally. I felt like a traitor if I complained, felt like a failure when I found out I was pregnant with our 4th child and I could no longer care for my mom.
The emotional, physical, and mental stress that a family caregiver goes through is intense. To this day I feel the stress of the time she was in my home. I think back to that time and know that if I had had a home health nurse come in, even two days a week, my stress level would have been much lower. My body was familiar with the physical stress, but others may not have the same training. As someone who has ‘been there’, I will always tell anyone that is considering whether or not to bring in a home health nurse or aide–it is worth it, if only to save your sanity.
Though home health care nursing agencies are often a great choice for people who require frequent in home care, some people choose to privately hire their nurses and nurses’ aides. It can be a tricky process, as the agencies usually pre-screen their employees for background checks and often drug use.
Having a stranger in your home on a regular basis can be stressful enough, but taking into account that these people will often be left alone with your loved ones and have access to your valuables, one can never be too careful. Should you choose to go the private route, one of the things you will definitely need to do is get a background check on your potential help.
Most states have background check departments, usually within their state police office. It usually costs between ten and twenty dollars to request a state police background check. Contact your local police department and learn the process, it’s usually as easy as requesting a background check application form and getting a photocopy of your applicant’s photo ID. Usually the form gets mailed away and can take a few weeks to return. The state police records will return anything that is on the criminal record of your applicant for the entire state. If your applicant has lived in another state, you may be able to get the same type of record from their previous residence. Federal background checks that list every offense someone has ever been charged with in the US are done by the FBI and can be a tricky thing to request. Your new hire will have to request the record check themselves.
You can request drug testing from your new hires. You will need to contact your local hospital or laboratory and you will be required to pay for the services, usually about $50 per test. You can buy testing kits from your local drug store. These are good in a pinch, they are not as accurate as having an actual lab test done.
One thing you may want to be very conscious of once you have hired your new employee is to take special care not to leave documents with your identification or that of your loved ones laying around for anyone to see. Identity theft is a very real problem and it could take as little as a credit card bill left on your kitchen table to get someone started on the path of causing your headaches and financial worry for months to come.
If you or a loved one has had recent surgery, a doctor may have prescribed aftercare in the form of rehabilitation services. Many nursing homes offer rehabilitation services. These services are in-facility and include after surgery care, meals, medication service, and physical therapy. These services are valuable, but can be expensive or may not be covered by your health insurance.
Many health insurance companies will cover a certain amount of time in nursing home rehabilitation services. This time covered is usually not long enough for full recuperation.
There is another alternative to this rehab. By utilizing home health care you can have access to rehabilitation services in your home. This can be used in place of rehab in a nursing home or after being discharged.
The positives of using a home health service for rehab are many. Probably the most important is the one on one care. When using a nursing home’s rehabilitation service, you must wait for therapy on the schedule of the nursing home. You must wait to use the bedpan or bathroom on their schedule. You are not the only person using the service – this will show in the amount of time that it takes aides to reach you after using the call bell.
If you do not have an aide or a nurse for a full shift, then you will be the focus for the entire therapy session. If you need help or have questions, that aide or nurse is focused only on you. No one else will be asking questions or asking for help. The staff member can take care of your needs right then and there.
Insurance may also pay for home health rehabilitation services for a longer period of time than for nursing home related services. This is because the expense of home health services are far less expensive. Nursing home care can cost over $300 a day while home health services can be as little as $100 a day.
When choosing rehab services, be sure to look into home health, it can save you a great deal of money and frustration!