Solutions at Home understands that people change, as do their needs. By providing geriatric care management, we can help you find the solution for your parents’ needs now and in the future.

It depends on the program. For example, the Solutions at Home Homecare program can include:

• Home visits by nurses, home care aides, and other healthcare professionals, depending on your individual care plan.
• Ongoing monitoring and evaluation of your parents’ health, comfort, and quality of life, with the plan adjusted as necessary.
• Help in understanding and managing medications
• Regular consultations and coordination between you, your care team and your family
• Regular contact and coordination with your personal physician to ensure your health care needs are coordinated.

Call Solutions at Home’s Connections Hotline at 800.544.0304 to find out what type of program will make the most sense for your parent.

The package of a la carte services available through Solutions at Home makes it easy for you to find someone to help your father stay home and live independently. We provide and supervise licensed, bonded, experienced certified home health aides who can support a full range of elder needs, from providing personal care (bathing, feeding) to household chores to medical support and overnight supervision.

If you decide to hire a home health aide on your own, be prepared to interview and manage that person, including all the paperwork required of employers.

You’ll want to make sure that person is reputable and dependable. You’ll want to authenticate certifications and licenses, check references and conduct a background check. Because this person will be your employee, you’ll need to negotiate a salary, maintain documents and filing local and federal forms. You’ll also need to develop a vacation and sick time policy and arranging for fill-in care. Even if the aide comes well-recommended, they may not be certified or bonded.

The Mayo Clinic offers this guide to selecting home health services

The most effective way to find the elder health care and support that is right for your parent is to have an assessment done by a professional geriatric care manager who will carefully match your parent’s medical, household and social needs with an array of senior care resources available through Solutions at Home as well as other specialty senior service providers.

You’re right to reach out. Being realistic about your skills and limitations will help you determine the senior services and support you’ll need. For example, can you lift your mother out of bed if that is needed? How can you be sure your mother is taking her medications? What if your mother has an accident when you are not around?

One way to assess the level of care you’ll be able to provide is to use this checklist

As you go through the checklist, you might find it includes tasks you hadn’t thought of.  It might raise some questions and concerns about your mother’s specific situation.

Once you have an assessment of the care you can comfortably provide, you may wish to call Solutions at Home for a consultation with a geriatric care manager. Our geriatric care managers will help you address your concerns and put together a plan that works best for your specific situation.

A geriatric care manager is a professional who specializes in assessing and arranging care for the elderly. Geriatric care managers often have training in gerontology, social work, nursing or counseling, and have extensive knowledge about the cost, quality and availability of elder services in the senior’s community. Some long-term care insurance policies will pay for geriatric care management services.

A geriatric care manager will with a complete assessment of needs and resources, so they can recommend and help implement the senior health and home care services you need for your parent. They can also be hired to stand in for family and friends in a variety of situations.

Here’s a detailed list of services that can be provided by a geriatric care manager:

• Conduct assessments to identify what eldercare services are needed
• Screen, arrange and monitor appropriate home health aides
• Provide or recommend onsite screening of elder’s home with an eye to falls prevention and practical accommodations
• Determine eligibility and coordinate senior health care benefits
• Review financial and legal issues and offer referrals to specialists to conserve assets and ensure compliance
• Provide crisis intervention
• Represent and act as a liaison to families living away from the parent
• Help move an older person to or from a nursing home or senior housing facility
• Offer counseling and support for the elder and the caregiver.

Selecting a geriatric care manager is an important decision. You want someone who will be responsive to you and is adept at communicating with health aides, organizations, medical professionals – and elders. For their work to be effective, you’ll need to share personal information about yourself, your family and your finances with a geriatric care manager.  You want to be sure to the manager you work with has the necessary training, appropriate certifications and expertise, and are guided by professional standards of practice and a code of ethics.  Geriatric care management is a relatively new profession, and is not widely regulated, so working with a reputable organization is particularly important. The geriatric care managers who are part Solutions at Home are seasoned professionals, who are well respected and known in the field.  They have been screened and trained, and as employees of Jewish Home Lifecare, one of the most experienced, respected organizations serving the needs of seniors.  In addition, they have access to a range of health and social service specialist through Jewish Home Lifecare, which enhances their ability to serve you.

The first step with Solutions at Home is a conversation with Connections, Jewish Home Lifecare’s free information and referral service .  You’ll talk to a skilled, experienced social worker who will help you to identify your next steps.  It will be helpful to have information related to your parent’s medical condition, personality, physical challenges.

Here’s a list of the topics that may be discussed:

• Personal Care: bathing, eating, dressing, toileting, grooming.
• Household Care: cooking, cleaning, laundry, shopping, finances.
• Health Care: medication management, physician’s appointments, physical therapy.
• Emotional Care: companionship, meaningful activities, conversation.
• Supervision: oversight for safety at home and wandering prevention.
• Home Safety: lighting, furniture configuration, rugs, wiring and external issues.
• Support Network: individuals who are local and play a regular role in the elder’s life

Senior care emergency checklist:

As a person responsible for elder care, you might want to keep a checklist with you at all times.   You can create your own, to include the items below, or download the form that follows and fill it out.

Here are items to include on your caregiver’s emergency list:

• Doctors' names, addresses, specialties and phone numbers.
• List of all medications being taken, dosage prescribed and what the prescriptions are for.  Be sure to keep this information up to date, as the medications may change frequently.
• Medical insurance and medication or prescription plans and identification numbers.
• Social security number.  Many insurance companies won't talk to anyone without the patient's social security number.
• Durable power of attorney. This is a legal document that assigns someone the authority to handle legal and financial issues if your parent becomes incapacitated.
• Health care proxy.  This legal document gives a designated individual the authority to make medical decisions for another in the event that this person lacks capacity.
• Notification of your elderly parent's wishes about resuscitation orders. It’s important to know this information before a crisis, so you can act according to your parent’s wishes.
• Basic financial records.  Have a list of assets, account numbers, names and contact information for financial advisors or bank representative.
• Names and addresses of people to notify in case of an emergency, such as children, grandchildren, close friends and neighbors who might be able to help out.
• Names and contact information for local clergy, if your parent or elderly relative has a preferred religious affiliation.
• Funeral/burial information.

This information should be placed in the home in an easy-to-find location, such as near the phone in the kitchen or in another commonly used area, as well as given to another family member or friend who agrees to keep a copy of the information for you.

Solutions at Home’s Home Health Aides provide elder care at home by assisting with eating, dressing, oral hygiene, bathing, colostomies, administering medications, etc. They may also provide homemaker services, such as light cleaning, meal preparation, laundry and escorting seniors to appointments and activities. These services may be covered by health insurance if ordered by a physician. Here’s a portrait of one of the Solutions at Home home health aides

What goes on behind closed doors is an understandable concern, especially if the elder has some cognitive loss or feels dependent on the homecare worker. Home health aides available through Solutions at Home are certified, bonded and licensed and supervised by nurses. Home health aides go through a rigorous application process including reference and background review, including criminal record checks. As employees of Jewish Home Lifecare, Solutions at Home home health aides receive ongoing in service training to keep their skills top-notch.

PERS stands for Personal Emergency Response System.  It’s a wearable elderly alert device that allows one to easily call for care in an emergency.  You may know it best as the “I’ve fallen and can’t get up” communicator.  Some systems have programs that call for help when no call from the elder has been made for 24 hours.

Your geriatric care manager can help identify the most cost–effective system for your parent’s specific needs.

You might consider a social day program, also called adult day care. This is a non-medically based program that provides structured, supportive but non-rehabilitative services in a protected setting for a portion of the day, one to seven days per week. Services may include recreational activities, social work services, hot meals, transportation, and occasionally, health services.

For more information on these services, please click here: Adult Day Program

Respite care services address your situation. Respite care services provide temporary, and in some instances, 24-hour care, to give relief to primary caregivers. The care may be provided in the person’s home, at an adult day care center, or other facility, ranging from one day to several weeks.

Jewish Home Lifecare operates a respite program. You can read about it here: Respite Care Services

Read about - One couple’s experience with respite care

Sometimes caregivers need ongoing support.  Here’s a  Link to a an online support group  

You’ll want to have a “discharge planning” meeting which will review the treatment plan recommended by your parent’s doctors and their thoughts about any elder care services you might want to engage. Your mother’s needs and abilities may have changed, so this should be factored into both short term and long term care plans. A geriatric care manager can help you with this transition from hospital to home. Here are some materials on leaving the hospital: A stay in the hospital is rarely an easy thing. For elders, hospitalization can often be the start of another transition. It is important to prepare for health related lifestyle changes – diet or medication adjustments, new support services, or housing changes, before being discharged from the hospital. What is discharge planning? Discharge planning starts from the moment a person is hospitalized. The discharge team’s purpose is to:

• provide education, guidance and support
• identify, assess and coordinate the support services that are needed to meet all care needs and ensure a safe living arrangement
• ensure that arrangements are in line with a person’s ability to pay/health insurance options

Although discharge is expected to be timely, by no means should it be rushed. It is a very important for the patient and family to be included in the decision making process related to discharge. Taking the time you need to communicate your questions to hospital staff will likely result in a successful and safe discharge. Here’s another - Resource to help with the transition process from hospital to home

This is a very significant problem for the elderly.  As we age, our risk for falls increases. Even a small fall can have significant impact on functioning.  Falls in the home are a major cause of hospitalizations and declines in health. Ask your geriatric care manager about the Falls Prevention program.  This set of services is designed to assess a senior’s risk for falls, in the hope of preventing falls before they happen, and to provide for a fall alert and rapid response if a fall occurs. As part of this package, an experienced professional will come to your mother’s home to assess both her health condition and her home environment.  From this, an individualized plan to reduce the risk for falls will be created, which may include:

• changes in diet, exercise and medication
• modifications to the home from furniture placement to color coding
• appropriate home medical alert or telehealth device

Here’s some general advice on Fall Prevention A slip and fall is a threat to the lives, independence and health of elders. Every 18 seconds, an older adult is treated in an emergency department for a fall. Every 35 minutes an elder dies as a result of his or her injury. Susan Holodak, MS, director of the Jewish Home Lifecare Adult Day Health Care program recommends taking these precautions to reduce the chances of falling: Start a regular exercise program. Following an exercise regimen is one of the most significant ways to reduce the chances of falling. It strengthens your body and helps you feel better. Exercises that improve balance and coordination (like Tai Chi) are the most beneficial.

• Lack of physical activity leads to weakness and increases the chances of falling.
• Talk to your doctor or health care expert about the best type of exercise program tailored to your abilities and needs.

Ask your physician to review your medicines. Your doctor or pharmacist should examine all the medicines you take (prescription drugs as well as non-prescription items such as cold medicines). Some medicines work differently as one ages, and the body changes. Certain prescriptions or combinations of medicines might make you drowsy or light-headed, which can lead to a fall. Check your vision. Have your eyes examined by an eye doctor. Your corrective prescription may have changed and you could be wearing the wrong glasses. Conditions such as glaucoma or cataracts limit your vision. Poor vision can add to your chances of falling.

Caring for Adults with Cognitive Impairments There are special caregiving challenges when an elder has slight physical ailments, but is cognitively impaired. Cognitive impairments can be completely different from patient to patient. Some typical symptoms that caregivers can find frustrating include:

• communication problems,
• aggressive or impulsive behavior
• paranoia
• memory issues
• poor judgment
• wandering

Many of these symptoms may require 24-hour supervision. Some people develop behavioral problems early on, and others can go their entire illness with only minor incidents. See our Tip Sheet:  8 Tips for Caring for Adults with Cognitive Impairments  

Solutions at Home is committed not only to providing services, but also to supporting caregivers and family members of elders. We offer many options, from resources and links to topical information and tip sheets to a  Caregiver support group.

You can also follow Solutions at Home on twitter @SolutionsatHome or visit our Facebook page.- pending

Here are more materials designed for family caregivers :

A Brief Guide to Home Care and Home Care: A Family Caregiver's Guide [detailed version] A Family Caregiver's Planner for Care at Home — An easy-to-use organizer for care at home - who is coming, and what will they do What Do I Need as a Family Caregiver? — A quick, practical self-assessment of what you can do, can't do, and want to learn...

There may come a time when you need to reconsider the choice of home health care. But how do you know if it is time to consider a nursing home? A geriatric care manager can assist with the determination. Here’s some information to guide to help guide your thinking: 5 Signs its Time to Consider a Nursing Home Many elders transfer to a nursing home after a hospital stay. For others, the need stems from a more gradual decline in health. Today, nursing homes are generally for people who need skilled nursing and 24-hour a day monitoring. Another option, geriatric care coordination, can be just what is needed when care needs overwhelm family caregivers, and can mitigate the need to relocate an elder to a nursing home. When is it time to consider moving to a nursing home? Here are five signs that it is time to consider nursing home care.

1. An elder is housebound.
2. Living at home is no longer safe for the elder.
3. The level of health care and assistance needed is increasing and becoming difficult to provide in the home.
4. An elder needs close monitoring because of declining health.
5. Other options are exhausted. For example, home care is no longer sufficient and other community based programs do not meet your needs.

In these cases, the medical and social facilities found in nursing homes may well offer the opportunity for the elder to enjoy a better quality of life. It is always wise to have a complete work-up at either an in- or out-patient geriatric assessment facility, typically sponsored by a hospital and a clinic. The better a caregiver understands the scope of an elder’s decline and its likely trajectory, the greater the likelihood that they will choose a safe, even empowering, fit for the elder. Here’s more information about nursing homes in Manhattan, Westchester and the Bronx from Jewish Home Lifecare. Skilled Nursing at Jewish Home Lifecare