Focus on: Senior Care in Dover, Somersworth, NH and surrounding areas

Providing care for seniors is sometimes a joint effort between a VNA or Hospice agency and a Homecare agency.

Each of these types of agencies specialize in a certain aspect of care. We often partner with other agencies in our area to provide care for seniors, one such agency is Wentworth Homecare and Hospice.

The professionals at Wentworth Homecare and Hospice provide compassionate Hospice care for seniors as well as home health care for those in Dover, NH and the surrounding area. We partner with them by providing homecare or hospice assistance services for families to have complete senior care for their loved one. 

If you are seeking Hospice care or hospice care assistance in the Dover, NH area consider a partnership between Abundant Blessings Homecare and Wentworth Homecare and Hospice to fullfill your senior care needs. 

Recently Wentworth Homecare and Hospice held a discussion on dementia with specifics on Alzheimer's. This discussion was conducted by Holly Cande, a transitional care social worker and was held at Mast Landing where Abundant Blessings Homecare has an office and provides homecare services. 

NEW YEAR….NEW YOU, Thoughts for Caregivers

Whether you're a caregiver for a family member or an in home care provider, New Years is a perfect time to reassess. Here's some thoughts from one of our senior care providers.

2016 silently tiptoed out for many people who were not into the blowing-horns-saluting-the-New Year-with-bubbly mode.  On tiny cat feet, 2016 quietly walked out the door, and gave a hug to 2017 while whispering in its ear, “treat every day with kindness and love”.  Those who greeted the New Year with reflections of the past year and a cup of hot cocoa or Earl Grey tea may be thinking of new ways to journey along the path of 2017.  Resolutions may include getting more exercise, cutting down on nibbling junk food while watching tv or get started on that endless honey-do list.

I’ve thought about “New Year Resolutions” and realize that despite my good intentions, my resolves to do this or that fall by the wayside a few weeks after the New Year begins. This realization triggered some thought about making an effort to “do better” in small but significant ways.  Making changes that would put smiles on the faces of those who are in your little corner of the world would be a good starting point. 

POSITIVE THOUGHTS

When waking up in the morning, focus on the power of positive thinking.  Instead of lamenting “Oh, great!  My plate is over-filled today. How can I get it all done?” Think, instead, “I should prioritize what I have to do today.  I know I’ll be able to do this because, first-off, I like to do these things and secondly, hey, I’m good at doing them!” That kind of thinking will get your creative juices flowing and also make you feel good about yourself. Giving yourself a pat on the back is a gentle push to get moving in a positive direction, not a negative one. This resolution will make your inner self ready to meet the day and give it your best efforts.

KIND WORDS

Brushing your teeth is part of your morning routine.  Why not add another must-do?  Make a conscious decision, each morning, to speak kindly to your family as they gear up for their day – whatever it may be. Too often the hustle-bustle of getting breakfast, grabbing important paperwork, feeding the pets, throwing on a load of laundry or figuring out what else needs to be done before you head out the door…result in unkind words being thrown at family members.  Criticism spews from a mouth like an angry volcano.  Those in the path of such words become defensive and then, in turn, ready to speak unkindly to others.  Remember, once spoken, words cannot ever be retrieved!  Sure, you can follow up with “what I meant was” or “sorry”, but the damage has been done.  The target of your ire just had a chunk taken out of their heart.  Now there is a dead spot on that heart where once was a smile. I speak from experience of being on the receiving end of words that went right to my heart and did damage – it hurts!  Yes, this will take big-time effort on your part but what a life-changer it will become when you make it routine.  Sending your family (and yourself) off to meet the day with smiles is awesome!  A great resolution!

SINCERE CARING

Too often we know someone who is experiencing a huge bump in their road and their day is falling apart. We may tell them we are sorry or off-handedly say “let me know if I can help” and then hope they won’t really ask us to do this or that.  After all, aren’t we all busy with our own lives? Or so we tell ourselves. Reach out to friends, family or acquaintances when they need help.  Put aside some time in your day to check in on them and, again, remind them you really want to help.  Caring about others does not have a time limit – it is endless!  And rightly so.  Sincerity is caring with you going the extra mile. Think about it. After all, when someone reaches out to us and then follows up with a phone call or knock on the door, isn’t our load somewhat lightened knowing that someone really cares enough to want to help – that it just wasn’t an off-hand gesture?  Sincere caring is a resolution that will bless them and your own heart, too.

LOVE YOURSELF

This may sound weird but it’s not! Do you feel unworthy/unable to be loved?  Then you need to take a good look at yourself in the mirror and tell that person staring back that they are a good person -- talented, caring, and worthy of love and respect. Don’t be bashful. Don’t think you are being egotistic. You aren’t. Do you know that the hardest person to love is yourself?  You know everything about you – what you perceive to be your good and bad points. But - to be able to give love to others, to care about them and to give the best you can whatever the situation -- you need to be coming from a place of inner strength, self-approval and knowing that you are valued.  Resolve to take stock of the person who wears your shoes. By doing this frequently, you will be reminded to smile at that reflection in the mirror.

DON’T JUMP TO CONCLUSIONS

How many of us form an opinion about a person or situation only to find out our idea of so and so or some event was totally off track? Rather than being patient, or listening intently or getting the whole story, we jumped the gun, thus putting a negative slant on a certain situation. How often have we hurt a person through word or action because we had formed a wrong conclusion? Make a New Year’s resolution to get all the facts. If you need to ask questions, then do so. 

BE BRAVE

It takes bravery to speak up about a situation that bothers you.  It is an injustice to a person if you don’t tell them if something they said or did is always on your mind.  I’ve always held to the premise that not saying anything when you need to means you really don’t care.  Having something eating at your heart and not talking about it is like an invisible rock hung on a chain around your heart – always heavy and wearing away at you.  I am not a person to make waves and I hate confrontation. But, there are times when I’ve had to take that very hard step to let someone know that something is wrong. I tell them that something they did or said is weighing heavy on my heart and we need to talk. When the air has been cleared, I can breathe easier and my heart steps lightly.  Resolve to clear the air and the sun will shine brighter for you!

WHAT DO THESE QUALITIES MAKE?

You may be asking how can these resolutions:  Positive Thoughts, Kind Words, Sincere Caring, Loving Yourself, Not Jumping to Conclusions and Be Brave have a connection with being a Caregiver?  Well, think about it. A Caregiver who starts their day with negative thoughts, biting words, off-handed offers to help, not being able to look in the mirror, making assumptions, or being too timid to clear the air walks into a client’s home dragging any of this name-it, claim-it baggage. Poof! Today’s road starts out rocky, not smooth. Adopting even one of these resolutions into your everyday life will put a spring into your step and a sincere smile on your face.  Your head will be ready to think, your hands will be ready to offer assistance and your heart will be ready to truly care about the person who needs you.  A Caregiver who is walking their New Year’s Resolution journey will bring sunshine and not gray skies to someone who needs to know they, too, are valued. Unlike winter’s sniffles, spreading these life-changing resolutions around would be awesome!

Whether you're a family caregiver or a homecare provider, what resolutions have you made which might help in your role as a caregiver?

Senior Health and Wellness Expo

Please join us at the Senior Health and Wellness Expo on April 6th from 10am-2pm at the Langdon Place of Dover. There will be many great vendors offering freebees, refreshments, offers, and great information on goods and services available to Seniors. Stop by and see our booth, meet some of our staff, take a moment to do our free Alzheimer's and Dementia Screening Test, and enter for a chance to win our beautiful gift bag! See you there!

Eight Reasons To Choose Homecare

by Vicki Salemi

As tough as it may be to enlist the help of a "stranger" when it comes to caring for your parents, sometimes it's for the best. For one thing, it will take the strain off of you, but your parent will also benefit from professional care in the comforts of home. Whether it's being attentive to special medical needs of assisting with personal care or homemaking, having a home health care professional will provide a variety of benefits to both the patient and the family. 

1 - Home care promotes healing.

"I know that our clients enjoy a much better quality of life which many families have said helped to extend the lives of their lived ones.," says Peter Ross, CEO and co-founder of Senior Helpers. "We focused on healing the mind, not just the body." Maxine Hochhauser, CEO of Visiting Nurse Regional Health Care System adds that in many circumstances the person rehabilitates better in the home. "They are in a familiar environment and are more comfortable. This is particularly true with individuals suffering from dementias." 

2 - Home care is safe.

"Many risks such as infection are eliminated or minimized when care is given at home," says Ross. Quality home care by professional caregivers can help prevent issues that may become very serious within the home. One example includes preventing falls in the home since seniors may be too weak or dizzy from medication since they fall when they're cleaning or bathing. 

3 - Home care allows for maximum amount of freedom for the individual.

Patients at home may be engaged with their typical daily activities as their health permits plus it allows patients to receive care in the least restrictive environment. "This is the most conducive to patient-centered care which allows individuals the most control over the care they'll receive and the manner in which they receive it," notes Hochhauser. "Plus, it allows individuals to remain in the community." 

4 - Home care gives them some control.

As baby boomers age the home care option gives them more control over the type of care they'll get to choose. Hochhauser explains, "They want more choices and want to be a more active participant in their own care. Home care allows them the most say in their care as they are in the least passive situation." 

5 - Home care is personalized.

According to Milca Pabon, RN, a home health care nurse with Adventist Home Health, "the best reason to choose home care is because the care that will be received in the home will be individualized to each patient according to their specific needs." Essentially home care is tailored to the needs of each patient as they receive one-on-one attention. 

6 - It eases burdens on the family.

Pabon explains, "With the length of stay in the hospital decreasing patients are going home earlier and many of them do not choose to go to a rehabilitation center to recover," explains Pabon. Rather, they want to go home to their own environment with their loved ones and have someone provide them with care they'll need to reach their maximum level of function. She continues, "Families are willing to have their loved ones with them, but may feel inadequate or unable to provide their loved ones with the help that they might need." 

7 - Home care is comfortable.

"Every study done has shown that people would prefer to stay in their home," says Constance Row, executive director of the American Academy of Home Care Physicians. There is familiarity and comfort of being in one's own environment surrounded by their loved ones. She notes, "It's a type of quality care that people would want for their senior relatives."

Source: http://www.seniorsforliving.com/content/article/eight-reasons-to-choose-home-care/18/

Falls in the Elderly

GEORGE F. FULLER, COL, MC, USA, White House Medical Clinic, Washington, D.C.

Am Fam Physician. 2000 Apr 1;61(7):2159-2168.

See related patient information handout on the causes of falls and tips for prevention, written by the author of this article.

Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can be markers of poor health and declining function, and they are often associated with significant morbidity. More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age. One third of community-dwelling elderly persons and 60 percent of nursing home residents fall each year. Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications, a directed physical examination and simple tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall and can return the patient to baseline function.

Elderly patients who have fallen should undergo a thorough evaluation. Determining and treating the underlying cause of a fall can return patients to baseline function and reduce the risk of recurrent falls. These measures can have a substantial impact on the morbidity and mortality of falls. The resultant gains in quality of life for patients and their caregivers are significant.

Epidemiology of Falls in the Elderly

From 1992 through 1995, 147 million injury-related visits were made to emergency departments in the United States.1 Falls were the leading cause of external injury, accounting for 24 percent of these visits.1 Emergency department visits related to falls are more common in children less than five years of age and adults 65 years of age and older. Compared with children, elderly persons who fall are 10 times more likely to be hospitalized and eight times more likely to die as the result of a fall.2

Trauma is the fifth leading cause of death in persons more than 65 years of age,3 and falls are responsible for 70 percent of accidental deaths in persons 75 years of age and older. The elderly, who represent 12 percent of the population, account for 75 percent of deaths from falls.4 The number of falls increases progressively with age in both sexes and all racial and ethnic groups.5 The injury rate for falls is highest among persons 85 years of age and older (e.g., 171 deaths per 100,000 white men in this age group).6

Annually, 1,800 falls directly result in death.7 Approximately 9,500 deaths in older Americans are associated with falls each year.8

Elderly persons who survive a fall experience significant morbidity. Hospital stays are almost twice as long in elderly patients who are hospitalized after a fall than in elderly patients who are admitted for another reason.9 Compared with elderly persons who do not fall, those who fall experience greater functional decline in activities of daily living (ADLs) and in physical and social activities,10 and they are at greater risk for subsequent institutionalization.11

Falls and concomitant instability can be markers of poor health and declining function.12 In older patients, a fall may be a non-specific presenting sign of many acute illnesses, such as pneumonia, urinary tract infection or myocardial infarction, or it may be the sign of acute exacerbation of a chronic disease.13 About one third (range: 15 to 44.9 percent) of community-dwelling elderly persons and up to 60 percent of nursing home residents fall each year; one half of these “fallers” have multiple episodes.14 Major injuries, including head trauma, soft tissue injuries, fractures and dislocations, occur in 5 to 15 percent of falls in any given year.15 Fractures account for 75 percent of serious injuries, with hip fractures occurring in 1 to 2 percent of falls.15

In 1996, more than 250,000 older Americans suffered fractured hips, at a cost in excess of $10 billion. More than 90 percent of hip fractures are associated with falls, and most of these fractures occur in persons more than 70 years of age.8 Hip fracture is the leading fall-related injury that results in hospitalization, with these hospital stays being significantly prolonged and costly.16 It is projected that more than 340,000 hip fractures will occur in the year 2000, and this incidence is expected to double by the middle of the 21st century.17

One fourth of elderly persons who sustain a hip fracture die within six months of the injury. More than 50 percent of older patients who survive hip fractures are discharged to a nursing home, and nearly one half of these patients are still in a nursing home one year later.18 Hip fracture survivors experience a 10 to 15 percent decrease in life expectancy and a meaningful decline in overall quality of life.

Most falls do not end in death or result in significant physical injury. However, the psychologic impact of a fall or near fall often results in a fear of falling and increasing self-restriction of activities. The fear of future falls and subsequent institutionalization often leads to dependence and increasing immobility, followed by functional deficits and a greater risk of falling

Elder Abuse, Neglect, and Exploitation

Protect yourself or your loved one

The elderly often rely on others to meet their most basic needs. Statistics tell us that about 9.5% of the elderly population is abused every year. Elder abuse includes neglect, physical abuse, financial exploitation, emotional abuse, and sexual abuse. One out of every 14 cases occurs domestically, usually within the victims homes. Abuse also occurs in nursing homes and other facilities. Physical Abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. This can happen even if the motives are good. For example we have seen family members who force there elderly mother into the tub, because she has dementia and would not cooperate. This forcing caused minor injuries. When confronted the family stated they were just doing what the nursing home did.  This is a shocking story, and often how physical abuse occurs. Psychological Abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. What is often just family conflict and strife can easily get out of control and lead to psychological abuse. Financial Abuse or exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. A family member, neighbor, friend, even a hired caregiver, anyone who is close to the person can manipulate and abuse them for personal selfish gain. Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder, or the failure on the part of an in-home service provider to provide necessary care. This can easily happen just by family members conveniently forgetting about their elderly parent. Caregiving is a hard stressful job, rather than properly finding the help that is needed. Ignoring the problem is abuse.

We all have the right to be free from abuse, neglect, and exploitation. If you suspect any form of abuse to an elderly person, it is important for you to report it. The types of abuse discussed above could happen to any of our community’s elders. Without intervention, abuse almost always escalates. Because victims are often reluctant to report abuse, a person’s safety may depend on you to recognize and report suspected abuse. It would be far safer for you to report a suspicion and be wrong, then remaining quiet while abuse occurs. It is important to know that more than two-thirds of elder abuse perpetrators are family members of the victims or close family friends, typically serving in a caregiving role. When elder abuse occurs, it can be addressed – if it comes to the attention of authorities.

If you need to hire homecare assistance, we recommend using a licensed agency rather than hiring privately. Homecare agencies must conduct criminal background checks, and BEAS registry checks. The BEAS registry (bureau of elderly and adult services) is a database containing information on founded reports of abuse, neglect or exploitation of incapacitated adults by a paid or volunteer caregiver, guardian or agent. There are individuals with a clear criminal background check who in in the BEAS registry. The NH BEAS registry can be reached at (603) 271-3269. Also, keep in mind; only criminals who get reported and charged have criminal records. Some homecare agencies and nursing facilities conduct pre-hire personality tests. These tests help determine if an applicant has a tendency toward certain types of crime or questionable behavior. 

Questions to Ask When Hiring Homecare Services

Providing care for a loved one can be stressful. Hiring homecare services should help relieve stress, not add to it. We made the following list to help make hiring a homecare service easier. 

Things to consider:

1.  Reputation:  Ask around. Ask your hospital discharge planner about any agency you are considering.  Rehabs or Nursing homes will usually provide you a list of agencies to consider. Senior centers and government services such as Service Link in New Hampshire are also great place to get information. Ask specifically about more than one agency for comparison purposes. 

2. Check out their website: The agency’s website should be thorough, informative and professional.

3. Ask to have a free in-home assessment. Any reputable agency should be willing and able to provide an assessment of your loved one’s needs. This meeting should be one that is not only for admission purposes, but also to answer the family’s questions or concerns. The homecare representative should be willing and able to answer and help guide the family toward the options they have, without pressure. They should be willing to be a resource for you whether you use their services or not. 

Questions to ask an agency:

1. Is your agency licensed by the state?

The states of Maine and New Hampshire require homecare agencies to be state licensed. New Hampshire also requires a state license for independent caregivers. If your family is considering hiring privately for care for your loved one please read our article on this topic "Use Caution When Hiring Independent Caregivers".

2. Will you take care of all required payroll paperwork for my loved one’s caregiver? Are your caregivers all employed by the agency?

The states of Maine and New Hampshire consider you an employer if you independently hire someone to work in your home. There is a large amount of paperwork involved in being an employer. This paperwork covers such matters as taxes, Social Security, workers compensation, disability, and liability insurance. One benefit of hiring an agency is that the agency normally does this for you. Even so, it is good to ask, as some agencies do use independent contractors as caregivers.

3. What kind of training do you provide for your caregivers?

To expect experienced and trained caregivers to work in homecare should be the minimum. However, it is important to ask if the hiring agency is training the caregiver themselves in addition to any formal training or schooling which the caregiver has had. What do they require for continuing education? Abundant Blessings Homecare’s new hire training and continuing education exceeds the state requirements in every area. Our RN is continuously adding and improving our training. We believe providing the very best training and continuing education will assure that our caregivers are the very best caregivers!

4. Do you conduct drug testing on your caregivers?

The states of Maine and New Hampshire do not require drug testing for home healthcare workers. Many homes in which home healthcare services are provided contain controlled substances, therefore we believe drug testing should be a vital part of the hiring process for any home care agency.

5. What kind of background check do you conduct on your caregivers?

Having peace of mind that your loved ones are in good hands is vital when hiring homecare services. The state of NH requires that homecare agencies in New Hampshire conduct only a State of New Hampshire criminal background check, not a Federal background check. They also do not require a motor vehicle driving record check. At Abundant Blessings Homecare we believe that State, Federal and Motor vehicle record checks are all essential when hiring homecare for a loved one. We run all three checks on all our caregivers. These additional checks are an added expense during the hiring process but we feel they are essential for peace of mind for your family. It is possible for someone to have a criminal record in another state which would show up on a Federal check and yet their New Hampshire background check would return "clear". We also believe motor vehicle background checks are imperative because often times home healthcare workers provide transportation for their clients.

6. Are your employees insured and bonded? 

The state of New Hampshire requires insurance of homecare agencies, but not bonding. However, insurance does not cover theft; bonding does. Also, not all liability insurance is the same. You could ask the agency for a copy of their policy or ask what their liability insurance covers. 

7. If at any time my loved one needs more hours of care (eg: 24 hour a day), or if a caregiver should call in sick, do you have the staff for coverage? 

Any agency you hire should have enough staff to cover these situations should they arise.

8. What is your policy regarding sending a caregiver to my loved one’s home whom my loved one has never met?  

It is not safe for an elderly person to be answering the door to total strangers. An agency should have a policy in place regarding the meeting of new caregivers. Abundant Blessings Homecare never sends new caregivers to a home blindly; we always conduct a “meet and greet”.

9. What kind of supervision do you provide? 

Once a caregiver is placed in the home of your loved one, ongoing supervision of that caregiver needs to be provided. How often can you expect a Care Manager/Supervisor to be available? Your family is assigned a Care Manager who you will get to know and trust as your go to person. At Abundant Blessings Homecare our phone number is always answered 24/7 by a real person and if your Care Manager is off when you call, you will be connected with whomever is providing coverage. In addition, we conduct drop in visits just to see how things are going on a regular basis. 

10. What kind of service agreement is required? What are your minimum number of hours?

All agencies have different policies. Find out what is required to be sure it will work for the needs of your loved one.

11. What is your method for tracking a caregiver’s arrival and departure from a clients home?

The agency should have a system in place for this that works for you and your family.

12. What are your hours of operation, and how are phone calls handled during odd hours? 

Abundant Blessings Homecare is available by phone 24/7, and is always answered by a real person!

13. Do you provide a written plan of care which clearly describes any rates and fees?

The state of New Hampshire has requirements which must be on the plan of care. The plan of care should be thorough and well    explained to your family.

14. How soon can you start services?

Your family may need homecare right away, yet the homecare agency may be too busy or too small to handle a quick start. They may need time to schedule services. This is a very important question to ask.