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

This past week has been a turning point in our life. An unexpected turn that came sooner than our family expected. It has been one of many emotional, psychological and at times, physically challenging, ups and downs.

As some of you know, my Mom was diagnosed with Alzheimer’s disease some years ago.

But, let me preface this chapter in our life with some history about Mom.

In the early stages of the disease, my Mom was always pretty self sufficient. She could do as she pleased with some care with the occasional forgetfulness of such as misplacing your car keys or other. You could be in discussion with her over any topic and she would ask whether she had told you something that she just told you?!? It was kind of perplexing and frustrating to the coherent of mind but, understandable to the goodwill of our human nature.

You know, it was a kind of peace, to know that is was only Alzheimer’s she was diagnosed with and not something else. There are so many different diseases that her forgetfulness could have lead to, it was a kind of peace to know it was a more common disease that more of the population had heard of. However, I wanted to research and teach myself more about this disease and glad I did.

She stayed at home with Dad for several enjoyable years during this time.

Though things worsened though Dad did a phenomenal job caring for her at home. Most days were good but, some were challenging. However, it was coming to the point, as it took its toll on him; she eventually was going to be put in a nursing home. Well, the day came when Dad called us three kids up and said the time was right to move her.

You know, it was a kind of peace, when she went into the nursing home. It was peace of mind for our family that she was being cared for 24/7 by professionals. It was also a form of peace that Dad would not have to worry about her certain type of care and well being at home without help.

At first, it was tough. I remember Dad having to give the nursing home instructions on how he wanted the care plan done for Mom over certain things such as her colostomy. That was consumer direction at its best. It was almost humorous to hear some of the stories of the nursing home taking care of Mom as they had never had to deal with a resident with a colostomy before. Oh, and don’t get Dad started on how hard they were on her clothes when they wash and dried them. We were buying her new outfits all the time. What a learning curve for both sides!

Mom stayed there for just over two years. Dad visited mom just about every day, too. The nursing home put on events for the residents all the time. Bingo, singers, musicians, ice cream socials (that dad always helped with), clown and magic acts, local Scouts coming by to sing Christmas carols, church was held at various times during the week, etc. The nursing home even had its own dog, employee ID badge attached to its collar and all. A gentle, caring yellow lab named Buckshot.

Needless to say, they kept the place active for the residents.

Last Thursday, May 31^st, I woke up at my usual time, grabbed a cup of coffee and went downstairs to my office. The phone rang about 6:00am and it was Dad telling us Mom had just passed away. The nursing home staff was helping her get comfortable in her bed just before this. She took a deep breath, grasped for air; they knew something had just happened. They called Dad and asked him to come down to the nursing home right away. She took her last breath as he entered her room a few minutes later. She died of a massive heart attack. People don’t die from Alzheimer’s; they die from complications from something else. Hers happened to be a heart attack.

You know, it was a kind of peace, when she passed away. Peace knowing that she is in a much, much better place today. Peace that our family can rest our hearts, minds and bodies knowing this, too.

It’s good to know, Aspirience Home Care can help you find that kind of peace with home care.

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