Author

Thomas Wiest

CEO, Aspirience Home Care

It still amazes me how many personal care assistant needs there are everywhere.

I was meeting someone at the Burnsville Center the other day and had some time on my hands.  I grabbed a cup of coffee and headed down to the food court to study some things.

As I was walking with my java in one hand and some paperwork in the other, here’s what I saw;

There was an older elderly woman being escorted by her walker.  You know the kind I mean, it has wheels on the two legs in front and usually two half cut tennis balls on the other two legs to help the walker glide better on surfaces. 

With a couple small packages at her side, she looked a bit lost as she was navigating her way around.  She stopped and took a pill box of medication out of her hand bag but, looked perplexed as to what to do next.  Should she take the pills now?   Is it the right time?  Are these the right pills even?

As I came down to the food court and found a place to sit and study, I saw a mother and daughter sitting together.  They were having lunch.  It appears they were having a very nice polite discussion of the recent rainy weather we’ve had. 

As I was sitting at a table nearby, the discussion turned to talks of caring for someone at home versus going into an institution like an assisted living center.  I don’t know if this was a relative, her husband, a neighbor or whom.  They were debating the benefits and the costs of the different home care avenues.  Which is the right choice?  How will I know I made the right choice?

Lastly, I wrapped up my study time and meeting and was walking out to the parking lot when I saw a young man in a motorized quadriplegic wheelchair hung up on one of the curbs.  He was moving his mouth piece back and forth, which controls the wheelchairs motion. 

Imagine being high centered in your car on a snow drift in a good Minnesota snowstorm, it’s the same thing.  He was frantically trying to free his vehicle but, to no avail.  I walked up and offered a hand of lifting the front end of his wheelchair off the curb so he could steer clear.  We smiled and nodded in thanks then we parted ways. 

The fact that is so startling is, if we just take a minute out of our day and look around, I mean really look around, it would amaze us how many personal care assistant needs there are everywhere, everyday.

It’s good to know, Aspirience Home Care can help you with all of them.

Author

Thomas Wiest

CEO, Aspirience Home Care

At 6:45pm on Wednesday evening I got an email from a colleague. She was asking if I was safe or at home with the family. I thought how sincere, how nice, but why? What’s going on? Obviously, there was something going on I was not aware of.

I was at my son’s basketball practice with my daughter helping the other coaches and players strategize the coming weekend games. My wife was out shopping. Yeah, we’re fine.

When I replied back that we we’re all OK and asked why, her exact email response was the following:

“35W bridge collapsed over the Mississippi at University, bumper to bumper traffic, many confirmed dead. So, happy you are SAFE with family.”

Honestly, I was paralyzed on the court from her email response. After a minute and the thought of what just happened settled in, I was blown away!

Immediately, I started searching mobile news stories on my phone. I couldn’t believe what I was reading nor the pictures I was seeing. Stuff like this doesn’t happen in Minnesota. This is something for either of the coasts, namely California where some sort of an earthquake would happen.

We all have so many connections with people around the Twin Cities: meeting with people in the south metro, north, downtown, etc. How could you not have traveled over that bridge at some point in time? How could you not have been affected some way, some how, to this tragic incident?

Needless, to say, the recovery efforts from all will be going on for a long time. There will be numerous people put in hospitals and maybe assisted living facilities while they recuperate and get better depending on their injuries and how self sustaining they can be with activities of daily living.

There’s going to be a gap in what they could do versus what they will be able to do now. It may take a while for them to get to where they feel their life is back to ‘normal’.

Again, our thoughts and prayers go out to all who have been affected by this tragedy.

It’s good to know, Aspirience Home Care can help you with home care whether it’s planned in advance or an emergency situation. We’re there to help!

Author

Thomas Wiest

CEO, Aspirience Home Care

Many people start needing care earlier on than we think to safely live at home. Not just seniors but also adults, young adults and most importantly, children. Their adult children can only do so much to directly help out because they work, have their own families and often live out of town.

When the time comes, what decisions should they consider?

Whether the need for care arrangements is sudden (a stroke, broken leg from a car accident, etc.) or gradual (dementia, autism in a child, etc.), the adult children/parents need to decide what their roles will be as much as possible. How will they help out on a day-to-day basis? What outside resources are needed? How will they oversee and evaluate the care?

That might sound simple, but it usually is difficult and stressful for several reasons: The senior parent requiring care may resist family or outside help; the adult children might not agree on an overall plan and their respective roles; they usually have no experience in making such decisions; and their busy lives allow limited time for any of this.

If there is more than one adult child, discussion and agreement of roles can prevent contention and bitterness. We have worked with family caregivers who neither asked for nor received offers of help from siblings. When more than one pitches in, the roles need to be collaborative, not necessarily equal.

It helps to develop a list that may include such tasks as arranging physical rehabilitation, checking in and monitoring medications, accompanying the parent or child to medical appointments, keeping the home stocked with food and supplies and preparing bills to be paid.

Usually, the list includes items that require outside resources; for example, arranging paid home care to assist with such activities as bathing, dressing, toileting, meals and safely moving about the home.

But the family might not be able to effectively make such decisions and spend a lot of time directly assisting the parent and arranging and overseeing outside services due to lack of available time or to living at a distance from the person needed care. There are approximately 5 million long-distance caregivers in the United States. Averaging 450 miles distance from their parents, or the person they are responsible of caring for. They often miss work, spend an average of nearly $400 per month on travel and other out-of-pocket expenses and feel stressed and worried.

We suggest long-distance family caregivers recognize what they can do from afar (scheduling appointments, paying bills, etc.) but, also rely on a local network of relatives, friends, neighbors and a reputable home care provider for checking in, reporting and peace of mind assistance.

We also recommend considering the help of a professional care manager (usually a nurse or social worker) who can assess the parent’s care needs and make recommendations, make and oversee care arrangements, provide medical advocacy and monitoring and report regularly to the family. A care manager can help overwhelmed local family caregivers in the same ways. Aspirience has an on site staff that can oversee all client care plans. Nothing gets overlooked.

Family caregivers generously jump in to help with care, sometimes with little thanks or support. They almost always experience stress and depression, and sometimes health problems due to lack of self-care.

Our advice is to avoid the “I can do it myself” syndrome by asking for help from your family and personal support system, and by finding outside information, support and service resources.

It’s good to know, Aspirience Home Care can help assist you in many ways with your home care needs, anywhere, anytime.

Author

Thomas Wiest

CEO, Aspirience Home Care

You know, I have been asked many times how does one go about getting Personal Care Assistant services in the first place. Who do you talk to? What needs to be done? Where do I go to begin with? It seems there are so many questions regarding this topic so I thought I would write a newsletter about it.

A person can receive PCA Services through one of the programs described below. Think of these as “doors” to starting PCA services, with each program differing in how it is administered.

PCA Programs

There are four different programs you can participate in to access PCA services:

• Alternative Care
• Home Care
• Home and Community-Based Waiver Programs
• Managed Care Programs

Alternative Care

Alternative Care is for people who are over 65 years but whose assets are too high to qualify for the Elderly Waiver.

Home Care

Home care is sometimes called Medical Assistance (MA) home care. PCA services are one of many services people on MA are eligible to receive.

Home and Community-Based Waiver Programs

A home and community-based waiver is an additional service that allows people to live in the community instead of going into or staying in an institutional setting. Types of waivers are:

• Community Alternative Care (CAC)
• Community Alternatives for Disabled Individuals (CADI)
• Elderly Waiver (EW)
• Mental Retardation/Related Conditions (MR/RC)
• Traumatic Brain Injury (TBI) Waiver

Managed Care Programs

Managed Care Programs are mandatory for people over age 65 years but an option for people with disabilities under age 65 years. Examples of managed care programs include the Prepaid Medical Assistant Program (PMAP) or Minnesota Disability Health Options (MNDHO).

Categories of PCA Services

There are four different categories of service you can receive in the PCA program:

1. Assistance with doing Activities of Daily Living (ADLs): These are things you do every day such as dressing, grooming, bathing, eating, positioning, transferring, toileting and mobility.

2. If your PCA assessment determines that you have a need for assistance with Activities of Daily Living, you may also use your PCA services for assistance with Instrumental Activities of Daily Living (IADLs), IADL assistance includes meal planning and preparation, managing your finances, shopping for food, clothing and other items, homemaking tasks, communicating by telephone or other means, getting around and participating in community activities.

3. Assistance in Health Related Functions, which are services that must be delegated or assigned by a licensed health care professional such as a nurse or doctor. Health related functions must be provided under the direction of a qualified professional (QP) or a doctor. Examples of health related functions are special skin care, non-sterile catheter care, tube feedings and respiratory assistance.

4. Redirection and intervention for behavior issues, which require observation and monitoring. For example, reminders to do activities of daily living or redirection of behavior that is potentially harmful to you or others.

PCA Assessment

First things first, an assessment must be completed to determine your need for assistance. The assessment reviews the tasks and assistance that you need and assigns a unit of time for these activities. The home care program you are in determines who will do your assessment. Here is a list of people who can complete an assessment:

• County public health nurse for MA home care or MR/RC Waiver program
• County case manager/service coordinator for CAC, CADI, TBI, EW Waiver programs or AC program
• Someone from your managed care plan (such as PMAP) if you are in a managed care program

This assessment should happen within 30 days after you contact someone about your need for PCA services. The assessment is done before PCA services can start and every year after that. To find out about your eligibility for PCA services, contact your local county agency.

It’s important to know, Aspirience Home Care can help you navigate through the home health care field to secure PCA services for you or your loved ones.

Author

Thomas Wiest

CEO, Aspirience Home Care

No one can argue with the fact that today’s fathers are more “hands on” with their kids. With so many dual income families, fathers often have to share the workload of childrearing and household chores. So how are fathers faring in this brave new world of changing diapers and driving carpools? With Father’s Day weekend here what a better time to look into this topic.

From what I see, read and hear, the verdict is mixed on how well today’s dads measure up - about half of the public says they’re doing a worse job when compared with fathers a generation ago and the other half says they’re doing as well or even better.

A broad consensus holds that it is harder to be a father now than it was 20 or 30 years ago, and on this point men and women agree. Fully 59% of men and 62% of women say today’s dads have a tougher time of it according to many studies.

Only 12% of the public, say it easier to be a dad today, while roughly a quarter say it’s about the same as it was a generation ago. People generally feel the same about motherhood. From studies I have read, seven-in-ten adults say it’s harder to be a mom today than it was in the past, and only 11% see it as easier.

Interestingly enough, when it comes to evaluating today’s fathers, dads’ harshest critics turn out not to be women, but other dads.

For example, on how good a job fathers are doing raising their kids, women actually have a more benevolent view. A majority (56%) of women say today’s dads are doing as good a job or a better job raising their kids compared with fathers a generation ago, while four-in-ten say they are doing a worse job according to a recent study.

Men, however, take a more critical view - only 41% of men say today’s dads match or better the performance of the dads of the 1970s and ’80s, compared with a majority (55%) who say today’s dads are doing a worse job.

Notable among the biggest fans of today’s dads is a group of women who may well be the best qualified to evaluate them - working moms. They’re married to these men after all, and they function at the epicenter of the busy households where modern dads must pitch in at every turn.

Fully 72% of married moms who work at least part-time and are raising young children say dads are now doing as good a job or better than their counterparts did a generation ago - only 26% say they’re falling short.

Mom’s Still the Head of the Household

Dads may be working harder at home and getting more involved in their kids’ lives these days, but we won’t know for another 20 to 30 years, when today’s children are fully grown, whether their fathers have succeeded in knocking their mothers off the top of the family pedestal.

Surveys of adult children show that mom, not dad, is the parent that they feel closest to and the person they turn to for advice. In a 2005 Pew Research Center survey, 61% of adults with both parents still living said they have the most contact with their mother. Only 18% said they have the most contact with their father.

In that survey, respondents were more than twice as likely to say they would turn to their mom in times of crisis (17%) as opposed to their dad (6%). And while 87% said they are close to their mother, fewer (74%) said the same about their relationship with their father. In this regard, dads rank below the family pet, not good. On average, dog and cat owners feel closer to their pets than adult children feel to their fathers. Talk about humbling!

Still, this may be okay with dads, simply because their relationship with their kids is less central to their own happiness than it is for moms. Many wives might be surprised to know that when asked about the most important aspect of their personal happiness and fulfillment, men are more likely to point to their relationship with their wife than their relationship with their kids.

Just the opposite is true for women. They place more value on their relationship with their kids than they do on their relationship with their husband. If you think about it, it is really about the kids and not us parents. Bringing the kids up right way for the right reasons no matter what.

It’s important to know, Aspirience Home Care celebrates the victories of all parents everywhere on Father’s Day.