Mum has a fall while ageing in place at home, and everything changes. If you haven’t had this experience, or one like it, but you have an ageing parent without in home care, chances are you will. Knowing what resources are available to prevent and support this scenario can make a huge difference. In home care can lessen stress, provide support, and speed up recovery. Non-medical in home care services, a nurse at home or in home health care while a parent or loved one is ageing in place can be your best friend. But what is the difference and how do I choose what is right for my family?
Non-medical in home care goes by a couple of different terms. It is important to distinguish between non-medical in home care and medical in home health care. Both can be critical to recovery and ongoing quality of life for someone ageing in place.
What is In Home Health Care?
In home health care provides limited medical support for those ageing in place. This includes nursing, physical, and occupational therapy, speech therapy, aids, and social work. A doctor’s referral is required for in home health care to begin and certain criteria must be met.
Typically, a doctor will request in home health care under these conditions:
- The person must be homebound. This means that leaving the home takes significant effort. If your parent or spouse is still driving, they probably will not qualify.
- There is a skilled need such as a nurse at home to manage medications, check blood sugar, blood pressure, or provide wound care to name a few.
- Waiting periods may apply in certain circumstances and the in home health care may be provided for a finite period.
- The skilled services offered by in home health care rarely exceed two to three times a week per discipline.
People who can benefit from in home health care may need help managing a chronic medical condition, or help recovering from hospitalisation, injury, or illness. Here is one example:
Daniel has Multiple Sclerosis and is confined most of the time to a wheelchair. He lives with his wife who does what she can to be his nurse at home and take care of him. Over time, he develops a pressure ulcer due to inactivity. This wound requires a stay in hospital and short-term rehab where his wound is treated, but not healed completely.
Once he goes home, he qualifies for in home health care. A wound care nurse visits him every week to provide in home nursing care, making sure the wound gets appropriate treatment and that Daniel does not sit too long. Since Daniel has a chronic neurological condition, the nurse can keep seeing Daniel for as long as is needed. A physical therapist also visits Daniel. She teaches Daniel and his wife the importance of regular position changes throughout the day so that Daniel does not get another wound.
So, what about in home care services? The terms are so similar, it is easy to confuse them. In home health care is medical and prescribed by a doctor, but in home care is non-medical and does not require a doctor’s referral or prescription. Let’s take a look at a typical scenario where in home care can be a critical layer of support and encouragement while ageing in place.
Betty is a 91-year-old woman in good general health and is ageing in place in a Retirement Village. She doesn’t use a walker or a cane. One day she loses her balance and falls against a railing on a walkway and breaks a rib. She goes to the emergency department of her local hospital and is sent home with pain medication. Her mobility is compromised, and she is confused about her medications. Her husband lives with her and could assist with care in the home, but he has his own medical problems, so his ability to provide in home care is limited. She is provided three in home health care visits each week by instruction from her GP.
But this is not enough support for Betty, so with the assistance of the social worker from the in home health care service, she calls a home care agency. The agency provides a Care Worker in the morning and evening, seven days a week. The Care Worker makes meals and does some light housework for Betty. The in home Care Worker also encourages Betty to walk, do her breathing exercises, and stands by while Betty is in the shower. The Care Worker also reminds Betty to take her medications. These have been set up in a weekly medication box by the nurse from in home health care.
As you can see in this story, an in home Care Workerhelps Betty recover more quickly, and more safely.
Most people as they age report a preference for ageing in place, in fact, surveys have shown that 77% of people prefer to remain at home as they age, but only half think they will be able to do so. The fact is many people who choose ageing in place will need support. With enough planning and in home care services, it is possible to successfully and independently enjoy ageing in place.
When considering the alternatives to ageing in place such as an aged care facility, common reasons to reject this option are to do with safety and autonomy. Outbreaks of COVID in aged care services across the country have given people pause. Lockdowns and elimination of extracurricular activities have had enormous negative impacts on aged care residents and their families. As a result, in home care is becoming a more attractive option.
When you think of in home care, you probably imagine a myriad of tasks that professional Care Workers provide. These tasks include assistance with bathing, dressing, cooking, hygiene, shopping, and cleaning. Looking beyond these activities of care are the fundamentals of what it means to be happy and healthy in the hands of a professional Care Worker.
A survey conducted by Home Care Assistance reveals some interesting findings that will probably resonate with you. Most seniors and their adult children agree that the two most important factors in receiving in home care are independence and maintaining control of everyday life. So, how do in home care service Care Workers promote independence and control while providing care?
Dependence and independence connect in very critical and subtle ways. Let’s take a look at how Care Workers provide safe in home care while promoting independence.
- People want to do things on their own but aren’t always able to. Care Workers encourage a client to do what they can while ageing in place. It is the little tasks that make all the difference. If your loved one can do limited cooking, a Care Worker encourages that activity rather than taking over all the meals.
- Everyone has something they can do well. Care Workers focus on a client’s strengths and abilities, not just what they need help with.
- Care Workers look for opportunities that maximise independence. Happiness and satisfaction come from the ability to do things for yourself while ageing in place.
Control
Maintaining control and autonomy are two keys to good mental and physical health while ageing in place. Control is the ability and belief that your decisions will have positive consequences. In recovery, disability, or illness, control is the driving force for positive and lasting change. Care Workers promote control by doing the following:
- Care Workers give your family member choices. No one likes to be told what to do and when to do it.
- Your loved one is in charge of their in home care. Being in control of in home care means being an active participant in your plan of care and identifying personal priorities. Care Workers give clients control by respecting their wishes.
- Care Workers identify what is essential to the client and honour those choices. If your loved one enjoys going for daily walks or listening to the opera, a Care Worker promotes and encourages these activities as part of their in home care services.
Dignity
The foundations of dignity are self-respect and self-worth. Depending on the Care Worker and client situation, intimate tasks need to be completed with extreme sensitivity. But dignity involves other critical components as well.
- A Care Worker acknowledges your loved one’s worth regardless of how vulnerable they may be.
- A Care Worker recognises your loved one’s unique attributes as a reflection of their values.
- The Care Worker client relationship is a partnership that honours the client’s beliefs, culture, and philosophy.
Successful Ageing
Much has been written about what successful ageing in place means and how to achieve it. There should be little doubt that a professional Care Worker’s ultimate goal is to help your loved one achieve successful ageing in place. These are the components of successful ageing and a Care Worker’s role:
- Interests and hobbies bring joy, satisfaction, and purpose to people’s lives. A Care Worker recognises, honours, encourages, and facilitates those activities.
- Cognitive stimulation helps individuals keep their minds active and vibrant. Care Workers work to help clients engage in mental activities for seniors that promote improved memory.
- If you have a loved one who is isolated due to physical challenges or limited access to transportation, Care Workers can help in several ways. Care Workers can provide transportation to preferred activities, whether it is to concerts, the theatre, or to visit friends. Care Workers can also engage in meaningful conversations and offer companionship.
- Healthy habits include good nutrition, hydration, activity, and adherence to medical directives. Care Workers motivate clients to adopt and maintain healthy habits while ageing in place as part of their in home care responsibilities.
In home care can be a vital lifeline. Although “in home care” Care Workers don’t provide medical services, there is so much more they can do:
1. Companionship and Socialisation
Loneliness has reached epidemic levels, especially due to recent increases in isolation. Loneliness and isolation in seniors ageing in place and in aged care services can adversely affect physical and mental health. A Care Worker can help end loneliness by being a nurturing and comforting companion. Research has shown that mentally engaging activities for seniors that a Care Worker can provide can have a positive influence on people’s mood and outlook on life while ageing in place.
2. Nutrition and Hydration
Nutrition and hydration are very important factors in recovery as well as daily living. A Care Worker can make balanced, appetizing meals. They can encourage adequate nutrition, track fluid intake, and shop for groceries.
3. Dressing, Bathing, and Transferring
Imagine you have broken your arm, shoulder, hip, rib, or leg. If you have had this experience you know how challenging it is to get dressed and to bathe. Not to mention cook, clean, and drive. An in home Care Worker can assist with helping someone get dressed and out of bed. They can help someone take a shower, monitor their walking, and can also help with transferring from the bed to the bathroom, or car.
4. Movement
Studies have shown that people with dementia can improve their mood with increased physical activity. Physical therapists provided by home healthcare can get the senior started on the right track. A Care Worker providing in home care services can help reinforce and encourage physical therapy activities when the physical therapist is not there.
5. Recovery
Recovery for most of us means getting back to our previous level of functioning, but recovery in older adults ageing in place generally takes longer. Returning to health can also be complicated by coexisting medical problems. A good care plan developed with the care manager, family, and client can encourage a safe recovery. The example below shows how a home Care Worker helps someone build confidence in recovery.
Carol has been in good health most of her life. She is independent and self-reliant, having learned to manage without her husband who died several years ago. One day she falls and breaks her hip. After surgery she is sent to rehab. Carol is terrified of going home even though she is doing well in rehab. She has a heightened fear of falling again. The in home health care staff begin working with her once she is discharged home.
Carol’s daughter Brenda notices that Carol’s lack of confidence in her abilities is hindering her recovery. Brenda hires in home Care Workers for daily visits to her mother. These Care Workers work with the physical therapist to learn the exercises that Carol has been doing. This way they can reinforce practice and take extra walks with Carol. The Care Workers assist Carol in the kitchen with making meals and doing light housework. In time, Carol gains back her independent and confident spirit.
6. Help with Medications
Medication mismanagement can be a big problem for those ageing in place. This can include not taking some medications, missing doses, or taking medications at the wrong time. Professional in home Care Workers can provide a medication management system,check the medication box for accuracy, and report any problems to the family and/or nurse at home or in home health care nurse. Care Workers can also pick up medications at the pharmacy.
7. Transportation
Transportation is a vital part of successfully ageing in place. This includes doctor’s appointments, shopping, medication pick-ups, and other errands. In home Care Workers can perform all these tasks as part of their in home care services.
8. Specialty Care for Alzheimer’s, Dementia, Cancer, and Parkinson’s
Types of dementias such as Alzheimer’s and Parkinson’s, among other conditions, can have a devastating impact on families. A hired in home Care Worker can provide mental stimulation, help with bathing, eating, and activity. Many agencies offer Care Workers who are familiar with the unique needs of Alzheimer’s and Dementia care, Cancer care, and Parkinson’s care. In these cases, an in home Care Worker can provide an added layer of care and companionship.
9. Primary Family Carer is No Longer Available
What happens when the primary family Carer is no longer available? Sometimes a caregiving spouse or family member will no longer be able to fulfill the role of nurse at home and provide in home care for their loved one. An in home care provider can step in and assume these duties, keeping a parent or spouse safe and stable with respite care.
Luckily, arranging for in home care is as simple as making a phone call. A GP referral is not required. During the initial call with an in home care agency you can describe the situation. Explain the needs of your parent or spouse, and the amount of time per day you think you would like some in home care. Whatever you arrange is flexible and subject to change based on individual needs. In home care staff can come to someone’s home, assisted living, aged care services, or a nursing home. It is flexible, supportive, and tailored to meet your spouse or parent’s needs.
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