Category: Silver Lining

  • 4 Steps To Take Mom’s Meds From Muddled To Methodical

    4 Steps To Take Mom’s Meds From Muddled To Methodical

    Medication management is a hot topic. And it should be. Medication confusion and home medication errors account for additional health expenses, hospital readmissions and even falls at home. Researchers at Brigham and Women’s Hospital (2012) noted that half of the people who go home from the hospital have medication errors and problems within the first month of discharge. According to an article in Drugs & Aging (2005), as many as 200,000 people may die of medication-related problems each year in the United States.

    Managing medications can be a real headache for some clients and families, as it requires time and attention to detail. And the headaches are no surprise when we consider the following circumstances that can contribute to the confusion:

    • Pharmacy substitutions – Pharmacies may change the brand of pill they dispense for your prescription (for example, substituting a generic brand). This usually means you’ll receive pills of a different size, color or shape even though you’ve been on the “same” medication for a long time.
    • Doctor to doctor communication – A cardiologist may reduce a medication from twice a day to once a day, but the primary care doctor has no idea.
    • Stop that. Start this. Medication changes are almost inevitable if you’ve been at the hospital or at a rehab facility. Additions or deletions from your daily med lineup can be confusing to a newly discharged patient. And if old medications are not disposed of or stored away, the confusion can be compounded.

    So let’s do this! Let’s go from muddled to methodical and get those medications under control for yourself or for someone in your care. Below are 3 easy, but important, steps you can take to gain better peace of mind and #happieraging when it comes to dealing with meds.

    1) Make the Mother List – Make one list identifying all medications that you and everyone in your circle (including your doctor) can reference. Keep it updated. Here is a printable one that Silver Lining Home Healthcare might use. If you’d like to complete a form on-line, you can find one here . Whether you use a template or create your own, these are the essentials of a complete medication list:

    • Medication Name(s)
    • Medication Dose (i.e. 10 mg, 5 mL 1 tsp, etc.)
    • Medication Amount (i.e. 1 tab or ½ tab) – This is the amount that you are supposed to take.
    • Frequency – How often and when?
    • Route – How is it taken (orally, sublingually, intravenously, etc.)?
    • Purpose – Some medications are used for different things

    Keep your list with you in a wallet or purse when you leave home and especially when you travel.  And remember, keep your list updated!

    2) Commit to one pharmacy. Find one you like and stick with it. All your prescriptions should be dispensed from here. Get to know the pharmacists and don’t hesitate to ask questions, even if it concerns an over-the-counter medicine. Your pharmacy may also deliver prescriptions right to your door. Just ask!

    3) Choose a medication pillboxor automated dispensing system – Visit your pharmacy and purchase a medication planner, also called a pillbox. If your medication doesn’t change often, go for the monthly one. If your medications are changing frequently, a two-week box may be better to get you started. Tips for choosing a medication planner:

    • Look for one that has big enough tabs for you to see and operate. Ezy Dose® Pill Planners and Medtime Planners® come in a variety of sizes. The Jon Locked Pill Dispenser adds another layer of convenience and assurance by locking all the tabs until it is time to dispense the medications. No more worries about spilling a planner and getting mixed up!
    • The first time you set these up, you may need to reorder some medications so you have enough to fill all your boxes and get all your meds on the same ordering cycle. Some medications will run out earlier than others and you don’t want to start getting confused about what medications are in the planners and which ones aren’t.
    • Always get a medication planner that has the correct time slots for you. For example, if you take medications three times a day, don’t get a pill planner that only has morning and night! This will cause more confusion.

    You may want to consider an automatic pill dispenser. With a little bit of time invested up-front, these work great and can even let a caregiver know via text messaging when medication is dispensed or if a dose was missed. It’s still a good idea to keep a pillbox on hand for vacations or times you’ll be away from home. Read more about automated dispensing systems in one of our past posts, Medication Management Tips and Tools.

    4) Talk, talk, talk to your doctor – Did you  know that the more medications you take, the bigger the chance you have of developing side effects related to those medications? Polypharmacy (when you take more than one medication) significantly contributes to medication-related issues, especially in the elderly. Talk to your doctor about:

    • Consolidating or even discontinuing some medications
    • Minimizing the times you have to take medications. Taking meds with less frequency during the day makes it easier to remember to take them. Instead of taking medications 4 or 5 times a day, see if you and your doctor can work to get your schedule down to 1 or 2 times a day.
    • Whether medications are appropriate for someone your age. You can do a little homework by reviewing the Beers Criteria for Geriatric Medication Safety to see if any medications you take could be cause for concern. Ask your doctor if he/she uses the Beers Criteria.

    As you talk to your doctor or the doctor of a loved one, be the advocate. Be the advocate by asking questions, sharing ideas, relaying symptoms and possible side-effects and by talking about anything that is concerning to you. Talk, talk talk!

    Get to it! Make your list, choose your medication planner (and use it consistently,) commit to one pharmacy, and stay in communication with your doctor. If you need assistance with medication management, call us! We can help! To look at our Medication Management plan and other services, visit our website here.

  • Gifts To Spread The Warmth This Holiday Season

    Gifts To Spread The Warmth This Holiday Season

    Sentiments of cheer and goodwill are certainly heart warmers at this time of year, but how about ways to literally give the gift of warmth? The team at Silver Lining Home Healthcare put on their (warm) thinking caps to come up with gift ideas to help friends and family stay warm; some will even battle the aches and pains that can worsen in colder months. Happy gifting!

    ARTHRITIS GLOVES

    They’re basically fingertip-less gloves that you can wear indoors as you go about your daily activities. They provide mild compression for warmth and help promote circulation. 5 top-rated brands are here for your perusal. Take them off only to wash your hands!

    Heated Slippers

    Give some toe-tickling comfort! Heated slippers can bring increased circulation and soothing relief to achy feet. Unlike socks, these slippers have flexible rubber soles, so you’re less likely to slip. And they can be worn indoor or outdoor, perfect for a dash to the mailbox.

    CHAIR YOGA

    Achy joints? Stiff knees? While it’s important for everyone to be active, it’s even more so for people who suffer from arthritis. Cold weather can hamper exercise routines, so having options for indoor activity is key. Give the gift of gentle movement and stretching. Chair yoga is a gentle way to warm up muscles and fend off stiffness. Check out 5 Chair Yoga DVDs developed for seniors. With the convenience of DVDs, these exercises can be done any time of day within the comfort of home-sweet-home. Namaste!

    WARM MEALS

    Cooking can become more difficult as we age, especially if you use a walker or can’t stand for long periods of time. Buy a slow cooker or dust off the one from the cupboard and introduce your loved one to some new recipes. Offer to help with grocery shopping and meal prep or ask your home health aide for assistance. Consider a meal delivery service as a great holiday gift, or connect with your local Meals on Wheels program to be sure nutritious and warm meals are a staple.

    REUSABLE WOOL DRYER BALLS AND ESSENTIAL OILS

    Bundle up some reusable wool dryer balls and essential oils with the suggestion that they be used any day of the week, not just on laundry day. Warm up blankets or sweaters for a few minutes in the dryer with this dynamic duo before wearing. The soothing warmth and relaxing, all-natural scent will chase away any winter chill. Dryer balls are a cost-saving alternative to dryer sheets, so they’re a gift that will keep on giving throughout the year.

    NOT-YOUR-EVERYDAY BLANKETS

    Sure, a blanket seems like such an obvious gift but we have three that stand out in our book:

    • Cabeau Fold ‘n Go Travel and Throw Blanket Plus Compact Case – Besides being so soft and plush, this blanket folds into a convenient carrying case for easy travel. Attach a carabiner to the handle and it’s ready to be attached to a walker. While the blanket is in the case you can also use it as a pillow, seat cushion, or lower back and lumbar support.
    • Electric Heated Throws – For those times that call for total body warmth, turn on an electric heated throw and snuggle in with a movie or a good book. Today’s heated throws come in so many styles and colors that it’s easy to match them to any décor.
    • Custom Photo Blankets – These blankets do double duty, warming hearts as they warm bodies. Family pictures, a family tree, or a family name are just some of the ideas to have imprinted on a blanket. Look for them at retailers such as Costco, Walmart or Shutterfly.

    HEATING PADS

    The options for heating pads are many–disposable, microwaveable, and electric. When that deep ache sets in, have the perfect one on hand.  ThermaCare disposable heating pads are great for those hard-to-reach spots and an adhesive keeps them in place. Microwaveable ones offer unlimited number of uses and many can be worn while you move through your day. We like the ones with velcro straps, like this lumbar and abdomen one or this one for your wrist. And don’t rule out an electric heating pad. In addition to the flat style (great for backs), they also come in a variety of designs for different body parts. Side note: We always encourage our clients to take advantage of the time with an electric heating pad to elevate their feet to help maintain positive blood and lymph flow!

    From all of us at Silver Lining Home Healthcare, may your aches be few and your warmth be plentiful this holiday season!

    Additional Resources:

    13 Arthritis Pain Relief Tips for Winter Weather

  • Tips And Tools For Medication Management

    Tips And Tools For Medication Management

    Different medications. Different dosages. Different times of day. It’s no wonder medication management can be a challenge for seniors. An effective plan for managing the medications of your loved one begins with 2 considerations–people and tools. Ask the questions (1) Who is the right person to oversee a loved one’s medications? and (2) What tools are available to assist in the correct delivery of medication?

    WHO’S IN CHARGE?

    Who comes to mind when you think of someone who is organized, competent, and trustworthy? The person you put in charge of managing someone’s medication should possess these traits. You might think of a daughter, a spouse, or a neighbor. You might think of a nurse.

    Nurse’s Note: If you decide to hire a nurse for any type of home care, make sure it is a nurse with an active license in your state. A Google search can help with license verification. Simply use your state in your search string, for example, “professional nurse license verification Delaware”.

    You can also choose a skilled home health agency (like Silver Lining Home Healthcare) for medication management. A skilled home health agency will ensure all their nurses are trained and licensed. They will also have backup nurses if your regular nurse is unavailable. Silver Lining Home Healthcare specifically offers a Medication Management program – book services today at our website: silverlininghealthcare.com.

    MEDICATION REMINDER AND DELIVERY TOOLS

    There are so many products on the market today that help ensure the accurate and timely delivery of medication. From simple pill boxes to more technological gadgets, there are delivery tools to suit many different needs.

    • Whether taking daily supplements and vitamins or prescription medications for specific conditions, many of us can appreciate a little help with planning and remembering to do so.  A pill box like the EZY Dose One-Day-At-A-Time at Walgreen’s makes it simple. We love the easy open tabs, the 2x and 4x per day options and the large bins for more medications. At under $10, this pill box is a great tool!
    • Consider a cell phone app. Most people have a cell phone and it’s something they usually have within close reach. Here are the top 5 medication apps that can help you or a loved one take the right medication at the right time.
    • A MedCenter Talking Alarm Clock is a timed voice prompt that can enhance the pill box method. A pre-recorded message (“Dad, time to take your pills.”) is scheduled to play throughout the day when it’s time to take medications.
    • The MedCenter Reminder System combines the talking alarm clock with a pill planner system that’s a bit more elaborate than a pill box. We love this system because there are separate compartments for each round of medications.

    Nurse’s Note: Many talking alarm systems come with a pill box system that opens one main lid to reveal all the individual compartments. Even though all the medications are separated and labeled for day and time, there is a greater chance of taking the pills from the wrong slot, forgetting what day it is,  or even spilling the entire container. We prefer separate closures for each day.

    The MedCenter Talking Alarm Clock and the MedCenter Reminder System work well for people who are competent, but, like many people, can be forgetful. If you are caring for someone who is not competent, you can still use these systems but we recommend having someone monitor them and watch for signs that indicate it is time to advance to a more sophisticated system. Some suggestions:

    • Livi is an automated pill dispensing machine that can hold up to 90 days of medications and dispense up to 15 pills at at a time. A caregiver can receive text alerts when medication is dispensed or if a dose is missed.
    • Phillips Automated Medication Dispensing Service is another option for complex medication management. Medication is loaded by a caregiver who provides the dispensing schedule to Phillips. Phillips programs the dispenser. An alert is sounded when it is time to take medication. At the push of a button, the pills are dispensed. The dispenser is connected to the telephone line, so if a dose is missed, the dispenser can contact you or another family member. You can then check on your loved one to make sure they are getting their medication.

    Once you’ve chosen a medical reminder and delivery system, our Medication Management Checklist is the perfect tool to help you get started. Use the steps we’ve outlined for you and you’ll be on your way to a streamlined and organized delivery system of your meds.

    Medication management is a critical component of a total care plan. According to an article in Drugs & Aging (2005), as many as 200,000 people may die of medication-related problems each year in the United States. There are so many options to help seniors and caregivers manage a safe and consistent medication plan. Call us today to learn more.

    Thank you to special contributor Amy Clark. Amy Clark is a Registered Nurse who is Silver Lining Home Healthcare’s Clinical Director. She has over 12 years in the healthcare field and excels at finding the resources her clients need to age happily at home.

  • Medical Alert Systems And How To Choose

    Medical Alert Systems And How To Choose

    A fall or a medical emergency is a concern in and of itself as we age. Being alone in such a situation is even more worrisome. Fortunately, today’s technology provides a myriad of options to monitor and respond to medical emergencies. Medical alert systems–also referred to as a personal emergency response system (PERS), a medical emergency response system (MERS) or a fall monitor–can provide increased independence and peace of mind. We believe they are an important part of a total care plan.

    RESEARCHING MEDICAL ALERT SYSTEMS

    So, where do you begin? For starters, AARP suggests you begin with these 5 considerations:

    1. What do you need the system to do? Today’s devices offer many capabilities. They can call for help at the push of a button, offer medication reminders, and use GPS tracking to monitor a person’s location, to name a few.
    2. What type of equipment would work best? A wearable device that’s comfortable and unobtrusive should be your first consideration.  Beyond that you’ll want to consider technological features such as battery life, connectivity, remote access by family members, and the logistics of setting it up.
    3. How are calls responded to and monitored? You’ll want to know what response times are (think seconds, not minutes), if call routing can be customized, and how does a company’s ongoing customer service measure up.
    4. How much will it cost? With the total cost of a system, expect to pay for the device, installation, and monthly fees (which range from $25 to $45 per month or about $1 per day). Discounts may be available for multiple family members in the same household, veterans, or low-income clients.
    5. Is the service available in your area? Make sure national companies offer service in your area. If a home security is already in place, your provider may offer medical alert services.

    4 SYSTEMS AT A GLANCE

    We’ve collected some information on 4 well-known brands of medical alert systems to help you start your search. In addition to using this table to assist your research, you’ll also want to ask the following questions:

    1. What is the length of a contract?
    2. Are sound alerts loud enough for someone who is hard of hearing?
    3. Will mom or dad actually push the button? Look for a brand that can monitor activity, provide activity information and reports, and set custom alerts. This allows you to be proactive and eliminate the need for a button to be pushed. SafeInHome is one brand we have found that offers this feature.
    Medical Alert Life Alert Philips Lifeline
    Monthly cost(Based on landline. Up to $15 more for cellular) $30 $50 $30-$45
    GPS option? If yes, monthly cost $5 $20 $10-$30
    Fall detection? If yes, monthly cost Yes. $10 Not offered Yes. $0-$15
    Activation fee None Up to $95 $0 – $15
    Cancellation fee None Varies None
    Monitoring capability 24/7 24/7 24/7
    Notes A lot of add-on options Medication dispenser and add-on options
    Contact info https://medicalalert.com/ lifealert.com https://www.lifeline.philips.com/

    SILVER LINING HOME HOME HEALTHCARE DELAWARE CAN HELP

    We recently installed a home monitoring system for a client who had mild dementia. The system allowed the daughter to see where mom was by using motion and pressure sensors (no cameras). It also allowed her to set parameters for when to get alerts. For example, if mom left the house between 10pm and 6am, the daughter would get an alert. All alerts were customized for different situations and the daughter was able to give us access to the system as well. This system, along with Silver Lining Home Home Healthcare caregivers being present 3 hours a day, allowed Mom to stay home for months longer than anyone thought possible.

    Home monitoring systems, in coordination with other resources and hands on care that Silver Lining Home Home Healthcare provides, are all part of an effective plan to age in place. At Silver Lining Home Home Healthcare Delaware, we can assist in selection and implementation of a system that works best for our clients’ needs. As caregivers, we pride ourselves on the personal, human touch that we give to our clients. But we would be remiss if we didn’t acknowledge–and promote–the important role technology plays in caregiving.

    Aging in place, while happy, is all about resources. What is the custom care you or your loved one needs to stay happy at home?

    Additional reading:

    How to Choose a Medical Alert System – A comparison of systems by Consumer Reports

    How to Choose a Medical Alert Systemby AARP

    10 Fall Prevention Tips for Seniors – by Silver Lining Home Home Healthcare

  • Documenting Your Life Story

    Documenting Your Life Story

    Perhaps you’ll notice the brevity in this month’s post. What I hope you will take away after reading is the heartfelt sentiment from which I write, hoping to encourage you to document your life story or that of a loved one.

    About 3.5 years ago, my husband and I came across a company called StoryCorps. StoryCorps has expertly crafted their skill in helping people—you guessed it—tell their stories. They facilitate conversations between all kinds of people—brothers and sisters, parents and children, best friends, grandparents and grandchildren. Their mission is, in their own words:

    “…to preserve and share humanity’s stories in order to build connections between people and create a more just and compassionate world.

    Over Mother’s Day weekend in 2016, we decided to enlist the help of StoryCorps to document the words and memories of my mother-in-law as she was battling cancer. We chose to do an audio and a video recording, so her grandchildren (her first was only 2 months old at the time) would get to hear her voice and see her expressions as she answered questions such as, How do you want to be remembered? What was your favorite trip you ever took?  Where did you grow up? These are questions we had not once thought to ask. She passed away 2 weeks later. We used excerpts from the StoryCorps recordings at her memorial service. Not a day passes that we aren’t grateful and comforted by them.

    Imagine having a connection to a grandparent you never met. Imagine the feeling of watching your loved one talk to grandchildren they will never know. And beyond all of these warm feelings of connection, there are actual health benefits to documenting your life story.

    Write it down, Dictate it. Record it. However you choose to document a life story, please make the time to do it. A simple internet search will uncover a variety of products that can offer prompts and formats to assist you. Capture the words of wisdom, the treasured memories and the irreplaceable sentiments that all too often slip away after a loved one is gone.

  • The What And Why Of Advance Directives

    The What And Why Of Advance Directives

    ADVANCE DIRECTIVES

    People often don’t know about them until the situation is less than ideal. We want to change that. Part of happier aging is planning for your future so everything doesn’t come crashing down without you and your loved ones being prepared. When you think about aging in place and happier aging, it’s important to remember the planning piece of the big picture. Advance directives, when properly prepared and executed, have the power to make very difficult times much easier. They can also ease today’s worries, giving you the peace of mind that allows you to live each day joyfully. Read on.

    WHAT ARE ADVANCE DIRECTIVES?

    You’ve probably heard stories of someone needing to give medical and/or financial direction for themselves, but were too ill or injured to carry out or express their desires. You may recall the 2005 case of Terry Schiavo that gripped the nation and ignited conversations about the need for advance directives. At the age of 25, Terri collapsed from heart failure resulting in massive brain damage that left her in a permanent vegetative state. From 1990 to 2005, Terri’s family battled over what Terri’s wishes would have been.

    Have you imagined what your wishes would be should you be unable to express them at such a time? Your next step should be to prepare your advance directives. Advance directives are legal documents that spell out your wishes for end-of-life care in the event that you are unable to do so. They allow you to direct ahead of time, your family, friends, and healthcare professionals, on how you would like your care decisions to be made. Advance directives include living wills and powers of attorney.

    HOW DO I GET A LIVING WILL?

    Visit an attorney for a standard living will form or you can complete one on your own. One of our favorite resources is the 5 Wishes. For a small fee, you can complete a living will online or via paper. It’s easy to understand, written in everyday language, and takes a holistic approach to writing a living will. A free online option is also available from the National Hospice and Palliative Care Organization and offers downloadable forms unique to each state. Depending on your location, specific state requirements may influence who has to sign your living will as a witness.

    You are never too young to create a living will and you can always change it later. If you do make changes, be sure to provide updated copies to all those who will be involved in your care–family, friends, and healthcare professionals.

    Don’t expect that you will complete your living will in one sitting. It is normal to want to discuss your feelings with loved ones and to contemplate end-of-life scenarios before committing your answers in writing. Take your time, but be sure to make the time.

    WHAT IS A POWER OF ATTORNEY?

    In its simplest terms, a power of attorney (POA) allows you (the principal) to decide who will act on your behalf if you become incapable of making decisions for yourself. The person who acts on behalf of you is called the agent.

    While there are several different types of POAs, know that when talking about advance directives the type of POA put in place is a durable POA. What’s the difference between a durable POA and a general POA?

    • A durable POA goes into effect when the principal becomes incapacitated and expires upon the principal’s death.
    • By contrast, a general POA expires when a principal becomes incapacitated.

    It is important to know the difference between the two and remember that when preparing advance directives you need a durable POA, not a general one.

    There are two types of durable POAs–medical and financial. You may wish to have one person handle your medical decisions and another to handle your financial matters, in which case you will have both types of POAs. Or you may want to have all decisions handled by the same person, so your durable POA would give medical and financial power to one agent.

    TODAY’S TO-DO

    There is no better time than today to add “GET ADVANCE DIRECTIVES” to your to-do list! We know that when plans for the future are put in place, people are happier, more confident, and less stressed in their daily lives. And we all know the feeling that comes from crossing something off of a to-do list!

    UPDATE: PLANNING IN THE AGE OF COVID-19

    Think about the last time you reviewed your will. Do you have one? Although grim, the current COVID-19 coronavirus pandemic has many Americans considering their end-of-life and estate plans for the first time.

    Additionally, a growing number of people in the United States are beginning to evaluate how prepared they are to deal with a serious medical emergency. Since the start of the coronavirus outbreak in the US,  online legal websites that provide legal documents such as last will and testament forms, do-not-resuscitate forms, and living will forms have all seen significant spikes in traffic.

    This increased interest in estate planning documents paints a dramatic picture of just how frightening this virus is, and illustrates how many Americans are choosing to take control of the situation now rather than later. Whether you’re new to planning your estate or already have existing documents on file, filling out the proper estate planning forms is a good precaution for everyone. Learn more about estate planning in the age of COVID-19.

    Special thanks to Jeanne Dukes of Lewes Counseling for contributing to this piece.

    Additional Reading:

    Advance Directives, MedlinePlus
    Things You Can and Can’t Do With Power of Attorney”
    5 Misconceptions About a Power of Attorney

  • Mental Competence And When To Step In For Mom And Dad

    Mental Competence And When To Step In For Mom And Dad

    There’s no doubt about it–helping your loved ones can be difficult. You observe little things at first, such as forgetfulness. You let it go for a while, but soon you find yourself trying to evaluate a host of “little things” that collectively are adding up to the big question, “Is Mom or Dad mentally competent?” We have some answers and also some tough questions to help you evaluate your situation. Read on for more in-depth answers, and see our 3 Quick Questions to Ask (at the end) when you’re not sure what to do.

    WHAT IS MENTAL COMPETENCE?

    According to the Public Legal Education and Information Service of New Brunswick, “Mental competence is the key to rational decision making. Unfortunately, disease or injury can affect the mind making it hard for a person of any age to make sound decisions. Sometimes it may be impossible for the person to look after themselves or their affairs.”

    WHEN DO YOU NEED TO STEP IN TO MAKE DECISIONS FOR MOM AND DAD?

    There’s no easily, identifiable time and there is no easy formula as to when you should step in. But you and any other caretakers need to have a conversation with your parents focused on SAFETY. Ideally, their physician would partake in this conversation as well.

    • For instance, you don’t want to take away their license, but they are forgetful so they go the wrong way or neglect to stop at the lights sometimes. That’s unsafe.
    • Or one morning when you visit Mom you realize the oven is on, from dinner the previous evening. That’s unsafe.

    Be mindful that you distinguish between a true safety issue and a “matter of opinion.” If a physician or other professional deems your concerns as your opinion, they will not be willing to take the reins from Mom or Dad just yet. Simply disagreeing on what is best doesn’t mean your loved one isn’t capable of making his/her own decisions.

    If it IS a safety issue, then it may  be an issue of mental competence and it is time to step in.

    WHEN YOU KNOW THEY NEED HELP, DO YOU MAKE ALL DECISIONS OR JUST SOME?

    If they’ll let you help make decisions, keep it simple and do it without getting involved in legalities. ALWAYS let them make as many decisions as possible, whether or not they are mentally competent. You can step in when necessary. No one likes to lose their freedom to choose, so even if they can’t drive anymore, be creative in the way you maintain their ability to have a say. “Do you want to go to the grocery store or the post office first?” “Would you like to stop for lunch before or after we pick up your prescription?” Choices like these can go a long way in helping them to feel valued and heard, at a time when they may otherwise be feeling a sense of loss.

    Start small–unless it’s a safety issue–and always give choices.

    WHAT IF MOM AND DAD DON’T WANT HELP?

    Difficult behaviors. That’s what they’re typically called in the medical world. And refusing help usually falls into this category. Reading and learning as much as you can about how to deal with difficult behaviors will be of great value to you as you navigate this chapter of your parents’ care. Even training for dementia and Alzheimer’s can be extremely helpful (whether or not your loved one has these diagnoses) because it helps you understand more about the aging process, signs to look out for, and helpful things you can do.

    If Mom and Dad don’t want help, you have a few options:

    1. If they are competent (they can make decisions for themselves mentally), you can continue to be a support, provide guidance and resources as they need it, and be alert for any changes in condition that indicate they may be unable to safely make decisions. And while there is nothing you can do to make your loved ones accept help, you can be prepared by understanding future options for care:
    2. Ensure there is a Living Will (Advanced Directive) and Power of Attorney items filled out (General, Medical, Financial are all types of Power of Attorney).
    3. Read our handout “How to Prepare for Your Golden Years
    4. If they are NOT competent (they can’t make decisions for themself) and you have a Power Of Attorney (POA), you can ensure the physician has them officially declared incompetent and then you can assume decision making for them.
    5. If they are NOT competent (they can’t make decisions for themself) and you do NOT have a POA, you can ensure the physician has them officially declared incompetent and consult an elder law attorney to ensure appropriate and legal documentation is created and implemented.

    3 QUICK QUESTIONS TO ASK WHEN YOU’RE NOT SURE WHAT TO DO:

    1. Is Mom or Dad mentally competent?

    2. Do I have our team ready?

    1. Find a good Elder Law Attorney (or Estate Planning attorney)
    2. Know the contact information for anyone else that needs to be involved with a decision for your parents (i.e., their siblings, their caretakers, additional family)
    3. Know the people involved in your loved ones medical care (doctors, social workers, case managers).

    3. Do I know what to do if Mom or Dad can’t help themselves anymore? See our Golden Years handout for good questions to consider.

    If your Mom or Dad doesn’t have the ability to make decisions but continues to do so, safety, quality of life, family relationships, and health can suffer quickly. The bottom line: Understand your options and make the best informed decision you can with the resources you have.

    Need some help going through the process? Find all our contact information at our website: silverlininghealthcare.com.

    Additional Resources:

  • What Happens After I Call A Home Care Agency?

    What Happens After I Call A Home Care Agency?

    While no two health care agencies operate exactly the same, there is a general sequence of steps that new clients can expect after they decide to make that initial call.  We’ve outlined the 5 steps you can expect when calling Silver Lining Home Healthcare. Let’s start with a fictitious, but very common, scenario:

    Mrs. Greeley is a 76 year-old who lives at home alone. She can no longer drive and, after her last appointment with the doctor, she knows she isn’t taking her medication properly. She’s also having a lot of trouble putting on her socks and shoes and almost fell last week trying to get the laundry down the steps. Her son Jason stops by and helps when he can, but he is concerned about his mother’s well-being. He isn’t sure what options he has so he begins an on-line search using terms such as “home health care” and “in-home care.” He is overwhelmed with the search results.

    1. Jason calls Silver Lining Home Healthcare and expresses that they don’t know what they want right now and just wants information. He’s wondering if he even called the right kind of company as there were so many to pick from. After asking a few questions, the Silver Lining Home Healthcare team determines that Jason has called the right place.
    2. A Consult specialist sets up a time that works for Jason and Mrs. Greeley to visit in her home and to talk about what home care is, other options that exist, what insurance covers, and budget options. Together they develop a care plan and schedule a home safety evaluation as required by Delaware state law.
    3. Mrs. Greeley, Jason, and the Silver Lining Home Healthcare team determine that 3 hours a day, 3 days a week will be a perfect fit for Mrs. Greely’s needs. Now it’s time to find the perfect caregiver for Mrs. Greeley! Focusing on personality traits, home environment (Mrs. Greeley has a cat so no one with a cat allergy!), and the required level of care, Silver Lining Home Healthcare sets up initial visits with their best caregivers.
    4. The customized care plan that was completed at the consult guides the care for Mrs. Greeley. Her plan focuses on dressing, doing errands, going to appointments, and general safety for quality of life. All the caregivers coming in know what to do and how to do it best for Mrs. Greeley. Warm transfers or buddy visits with any new caregiver are provided so everyone feels comfortable!
    5. Jason and Mrs. Greeley receive monthly calls from Staci at the Silver Lining Home Healthcare office to check in, and Jason gets an email survey every 3 months (since he’s Mrs. Greeley’s main contact). Their nurse, Angela, sees them every 60 days to ensure the care plan hasn’t changed and that Silver Lining Home Healthcare is delivering the peace of mind we promised!

    Call with confidence knowing what to expect after the friendly voice on the other end of the line says, “Thank you for calling Silver Lining Home Healthcare.” We’re waiting to hear from you!

  • Caregiver Credentials

    Caregiver Credentials

    KNOW WHO’S CARING FOR YOUR LOVED ONE

    Have you ever been to a doctor’s appointment or had a visit to the hospital and noticed how many different medical personnel there can be tending to you? Unless you ask, it can be hard to know exactly what each person’s job title is let alone what credentials they carry. The same can be true for home care. Are all nurses the same? How does a Certified Nurse Assistant differ from a Companion?

    BE IN THE KNOW

    First and foremost, any company coming into your home should be licensed, bonded and insured. Don’t be afraid to ask for proof of business license, home health license, and insurance. You can also do an entity search (in any state) to be sure the company is in good standing. A free search will allow you to verify that a company has an active license in the state you are searching.

    There are many people who may play a part in your wellness journey or that of your loved one. Let’s take a look at some you may meet along the way.

    REGISTERED NURSE (RN)

    Registered Nurses are the primary go-to practitioner for most doctor’s offices, hospitals, and facilities because they can do almost anything a physician orders, are trained on assessments, and have the expertise and critical thinking skills to operate without extensive oversight. RNs coordinate care, perform diagnostic test and analyze results, instruct patients on how to manage illnesses after treatment, and oversee other workers such as LPNs, nursing aides, and home care aides.

    Registered Nurses all have to pass the same exam nationwide, called the National Council Licensure Exam (NCLEX) for Registered Nurses. Some RN’s start with an Associate Degree (ADN) and some have a Bachelor of Science in Nursing (BSN). Regardless of level of education, all have to pass the same test.

    Silver Lining Home Healthcare has Registered Nurses overseeing all care and working closely with LPNs and CNAs to administer the right customized care.

    LICENSED PRACTICAL NURSE (LPN)

    An LPN reports directly to an RN and can carry out most of the same job responsibilities, with a few tasks that they must have an RN do for them. They are responsible for the tasks associated with the care of their patients and are expected to report even minor changes in a patient to an RN or other medical professional. Typically, becoming an LPN requires about a year of education culminating in a certificate. An individual must pass the National Council Licensure Examination for Practical Nurses.

    CERTIFIED NURSING ASSISTANT (CNA)

    A CNA assists patients with activities of daily living, monitors medication reminders and vitals, and offers emotional, physical, and social support. A CNA reports to an LPN or RN, and will always have oversight. He or she will have 75-150 hours of training in a CNA program and must pass a state-sanctioned competency test.

    MEDICAL ASSISTANT

    You probably know the medical assistant as the person you meet upon entering an exam room at a doctor’s office. He or she will ask you for some health history, record information, and may take your vitals. A medical assistant will also perform appointment scheduling and data entry. Completion of a one year certificate program or Associate Degree is standard; certification is not legally mandated. This person differs from a CNA in the type of training; CNAs are typically more trained for ‘hands-on’ care like bathing/dressing, while a Medical Assistant may be more trained in procedures like performing an EKG (a heart monitoring test) or doing lab draws.

    COMPANION

    Hiring a Companion is a great way to provide personal assistance, light housekeeping and meal preparation, and friendship for your loved one who otherwise would spend much of their time alone. While there is no formal schooling required, requirements will vary from employer to employer. Employers will consider not just work experience, but life experience as well. They’ll look for individuals committed to helping others with warmth and compassion.

    PHYSICAL THERAPIST (PT)

    A Physical Therapist, often referred to as a PT, may visit your loved one’s home to help him or her restore function, improve mobility, relieve pain or prevent or limit permanent physical disabilities through exercises and treatments. A PT will hold a Doctor of Physical Therapy Degree (DPT) and have passed the National Physical Therapy Exam.

    Physical Therapist Assistants (PTA) work under the supervision of a PT and help administer treatment plans as directed by the PT. To become a PTA one must graduate from a 2-year accredited program and pass a licensure exam.

    OCCUPATIONAL THERAPIST (OT)

    An Occupational Therapist helps patients who are injured, ill, or disabled through the therapeutic use of everyday activities. They help them  develop, recover, improve, and maintain the skills needed for daily living and working. Often an OT will assess home and work environments and recommend adaptations that will improve one’s quality of living.

    A master’s degree is required to become an OT and an associate degree is needed to become and OT Assistant. Both professions require passing the National Board for Certification of Occupational Therapy exam followed by state licensure.

    SOCIAL WORKER

    A social worker is committed to improving the social environment and well-being of people by facilitating, and developing resources. Our social worker at Silver Lining Home Healthcare is Jeanne Dukes of Lewes Counseling. Jeanne is an invaluable resource in helping seniors transition to home health care, and for understanding a variety of other options. She also specializes in mental health.

    QUESTIONS TO ASK A HOME CARE PROVIDER

    Regardless of who is coming into your loved one’s home to provide care, be prepared to ask some important questions, such as:

    • Who is in charge of my care?
    • Will I see you regularly?
    • What can I expect you to do when you’re here?
    • What is the best contact number to reach my point of care?
    • Can I access you 24/7?
    • Any other questions that may be unique to your loved one’s situation or preferences.

    And don’t forget about questions that are more personal in nature, the kind that go beyond the credentials someone carries, such as:

    • What made you decide to become a [fill in the blank]?
    • How long have you been in this field?
    • Are you from this area?
    • What do you like to do when you’re not working?

    At Silver Lining Home Healthcare, we are all about building client relationships that feel like family. We want to know what makes your loved one’s heart sing and what fulfills his or her days. We welcome questions from our clients that will help them know and trust our caregivers and set them on a path of home health care that is rooted in trust and compassion.

    SOURCES/ADDITIONAL READING:

    “LPNs vs RNs.” NusingLicensure.org, www.nursinglicensure.org/articles/lpn-versus-rn.html.

    “Differences Between Occupational Therapy and Physical Therapy.” PHYSICAL THERAPY WEB, www.physicaltherapyweb.com/differences-occupational-therapy-physical-therapy/.

    “Become a Social Worker.” Social Work License Map, www.socialworklicensemap.com/become-a-social-worker/.

  • Levels Of Care At Home: Determining Needs And Understanding Options

    Levels Of Care At Home: Determining Needs And Understanding Options

    Are you looking for home care for a loved one but not sure where to begin? Perhaps you’re seeing clues that mom or dad could use some help at home. Or maybe your search is more urgent as in the case of a pending hospital discharge that’s happening faster than you anticipated.

    Stop. Take a breath. Silver Lining Home Healthcare can help you determine how much or how little care your loved one needs and provide that care in the comfort of his or her home.

    Let’s start with how much care. We’ve devised a simple-to-use Level of Needs Calculator, as a tool to determine how much care someone needs. Use this as a guide, keeping in mind that every situation is different and for that reason, we always customize and tailor care for our clients. Our clients are all unique; their care should be, too!

    LEVEL OF NEED CALCULATOR

    The amount of care your loved one needs is part of the picture. The other part is the type of care needed. There are 2 types of care—non-medical/non-skilled and medical/skilled.  Silver Lining Home Healthcare can provide both.

    1.     Non-medical/non-skilled – This type of care includes companion and personal care. It does not always require a physician’s order. Care can be provided by a companion who is not required to have medical training or by a Certified Nursing Assistant (CNA). A CNA is required to complete a state-approved program with practicum experience. Running errands, providing transportation, bathing, dressing, and cooking are all examples of the type of care provided at this level.

    2.     Medical/Skilled – This level of care always requires a physician’s order. It includes nursing and therapy services and can only be done by Skilled Home Health Agencies, like Silver Lining Home Healthcare. Care is always provided by a licensed professional, such as a Registered Nurse, a Licensed Practical Nurse, an Occupational Therapist, or Speech Therapist.

    Sometimes, getting your parents or loved one to accept help can be a challenge. If you’re worried about having this conversation with them, speaking to a professional at Silver Lining Home Healthcare beforehand can help prepare you. Likewise, if you’re not sure about what exactly they need, don’t let a feeling of uncertainty stop you from learning more. We’re here to listen, advise, and if needed, devise a home care plan that promotes happier aging for your loved one and you.