posted on April 23, 2012
Amy Newton, OTR/L
Home care and Parkinson Disease are not a combination that people often place together. Our unique interdisciplinary team assists those in varying stages of parkinson disease obtain therapy, social work and nursing care in order to remain independent in their home.
Several months ago, our team helped a patient in the community with parkinson disease who had fallen, broken her wrist and was relying on family to assist her daily whereas prior to her fall she was independent in her home. Physical therapy provided her with an exercise program, educated her on use of walker which she did not use before and educated her on ways to prevent freezing which may have caused her fall.
Occupational therapy assisted with making suggestions for safety in the home, cooking and getting dressed. She was also given exercises to strengthen her wrist. The nurse educated the patient on her parkinson medications, instructed on side effects and how to take the medications to ensure that her symptoms were under control. A social worker assisted the patient and family with community resource.
When she graduated from requiring home care services the patient then attended an exercise class in the community that was taught by one of her therapists as well as attending a support group provided by the homecare company. If you or someone in your family have parkinson disease, consider getting a referral from your doctor for homecare in order to live life to the fullest in your home!
posted on April 17, 2012
Lynn Maxim, LMSW, Geriatric Care Manager
What is one of the most important legal documents every adult should have? It is a Power of Attorney.
Why is it so important? A Power of Attorney is a document that allows an individual (who you choose) to make decisions on your behalf. If something were to happen to you and you do not have a Power of Attorney, your loved ones would be forced to file for Guardianship.
Guardianship proceedings cost thousands of dollars and take valuable time. Think about who you would trust to make decisions on your behalf and visit an elder law attorney to have a Power of Attorney prepared.
A Power of Attorney was formerly a simple, one page document that you could download from the internet. Within the last several years this document was revised and it is now a longer and more complex document. A power of attorney can be limited to a specific act or it can be general. There are different types of power of attorney; the ones most related to medical care are referred to as durable and medical.
It is important to work with your family members and loved ones and decide who would best fulfill your wishes if you are no longer able to speak for yourself. This is a serious decision and should be thought out, but it is also very important to make sure you complete a power of attorney as a part of your long term planning.
posted on April 11, 2012
Keri Finzer, Occupational Therapist, COS-C
In honor of Occupational Therapy Month the HCR OTs wanted to bring more awareness to our often misunderstood profession.
As an Occupational Therapist, I often smile when some of my new patients say to me, “Occupational Therapy? Why Occupational? I don’t need a job!” Sometimes patients are confused when they first hear the name of our profession. They also may not know why their physician has prescribed Occupational Therapy for them. Simply put, Occupational Therapy concentrates on what occupies a patient’s time. OT is designed to restore a patient's ability to perform tasks and rebuild independence allowing them to participate in daily activities, creating ways for them to live a full life no matter what!
Occupational Therapy concentrates on what matters the most to the patient. Occupational Therapists (OT) and OT Assistants focus on patients ‘doing’ whatever activities are meaningful to them. It is our goal to get beyond a patient’s illness or injury by developing solutions for them. These solutions may be adaptations for how to do a task, such as putting on socks without back pain… or making changes to a home, such as adding a shower chair, or helping patients alter their habits or routine because of failing vision. We use everyday activities as the means to enable people to thrive.
OT is a practice deeply-rooted in science and is ‘evidence-based,’ meaning the plan designed for each individual is supported by data, experience, and best practices which have been developed and proven over time.
Occupational Therapy looks at the whole person, including the psychological, physical, emotional, and social, and environmental. OT promotes health and the prevention of injury, illness, or disability (or to help patients live better with their ailments). Again, Occupational Therapy concentrates on what matters the most to the patient – allowing them to participate in daily activities and let them to live life to its fullest!
posted on April 3, 2012
Lynn Maxim, LMSW, Geriatric Care Manager
Defined simply, a Geriatric Care Manager is an individual who helps seniors and their families navigate the various systems and resources applicable to the aging. A Geriatric Care Manager acts as an advocate and liaison. They can educate you about Medicaid, Medicare, and other insurance coverage including Veterans’ benefits.
When a change of residence is necessary, a care manager can make recommendations about the appropriate level of housing, such as independent, assisted living, or nursing home. A care manager begins working with a family by completing a thorough assessment of the elder in their home environment. This includes a financial, legal, physical, and psychological evaluation.
Geriatric Care Managers often make referrals to other professionals, including elder law attorneys, in order to help protect the assets of the elderly individual so that care can be maintained for the rest of their lives. Geriatric Care Managers can also serve as a liasion for family members who live far from their parents or loved. They can help you better understand your loved one's personal and medical needs.
Today's seniors may transitions through many phases of health that require a variety of different services. Whether your family member has one or several physicians, a geriatric care manager can help communicate with them, managing appointments and care.
posted on February 23, 2012
Carmen Camacho, RN, BSN
Statistics show that people of color have a shorter life expectancy than other ethnic groups. We tend to die from lifestyle diseases that can largely be attributed to our diets.
The National Institute of Health (NIH) reports that people of color have higher rates of cardiovascular diseases (high blood pressure, stroke), cancer, asthma and diabetes. Many African Americans were raised on “soul food” diets, which tend to be very high in fat, cholesterol, and sodium. We enjoy these foods and the way we prepare them. We have been reluctant to change what we eat or use healthier alternatives. The way we eat also has contributed to increased obesity rates in our community. (39% vs 24%).
People of color are also more likely to be without a primary care physician or health insurance. Some fear going to the doctor. They put off problems that could be treated or managed, until they have developed into something more serious. In Monroe County, among adults 18 years and older, African Americans (24%) are more likely than whites (12%) to report their health as fair or poor.
Now is the time to do what we can to improve our health and encourage a healthier diet for our families. Try recipes that have been developed, which teach ways to prepare the foods we enjoy, in more health conscious ways. We all want quantity of life, but that is no good without quality of life!
posted on February 16, 2012
Rina Schnaufer, RN and Joetta DeVeronica, RN
Telemonitoring systems, such as Cardiocom®, can help home health care providers address a large percentage of our patient population such as those with Hypertension, Heart Failure, COPD, Asthma, CAD, and/or Diabetes, amongst other possibilities.
The Cardiocom® systems are installed in the patient’s home for remote monitoring. Information is sent through a telephone or internet line and then we are able to monitor vital signs along with the symptoms of the disease. Reminders can also be sent to patients and calls made to help to improve overall patient compliance with treatment care plans. The goal is to identify symptomatic patients and intervene early to prevent unnecessary hospitalizations, as well as to support health outcomes, interdisciplinary communication, and optimize care.
Below is an example of how Telehealth monitoring can connect patients, home care clinicians, and their physicians to their daily status.
This patient was refe
rred to our Telehealth Team for a diagnosis of heart failure. After several days of monitoring, we noticed a trend of elevated blood pressures in the morning. The blood pressures would range from 200's/100's in the morning to normal readings in the afternoon (per HCR standard parameter guidelines, normal BP readings are 160/80). The patient and physician were unaware this was happening. After contacting the physician and providing the Telehealth reports, the physician was able to make the necessary medication changes and the patient's blood pressures are now stable.
Telehealth provides your patients with the opportunity to be connected to their medical team daily. This gives patients and families a sense of security, confidence, and independence. Telehealth also provides for clinicians a regularly scheduled report to support your clinical assessments. Telehealth monitoring is an important part of a patient's home health care plan and provides valuable information to the entire healthcare team and the patient on a daily basis.
Many more HCR patients could benefit from Telehealth; the above is only one example of many. There have been numerous times when Telehealth has been an important and helpful tool providing daily monitoring and can help to truly provide thorough quality care. To learn more information about HCR’s Telehealth Program or to inquire directly, click here.
posted on February 9, 2012
Chris Chimenti, MSPT - Director of Therapeutic Services
It’s amazing how much Home health practice has changed over just a few years. When I began my career as a home health Physical Therapist in 1999, a stack of new referrals, a variety of paper documentation forms, a pen, and a pager were standard issue for home care field clinicians.
The pager was my lifeline to the home office. When the office needed to contact me, I would get a page containing the office phone number. (The phone number followed by the numbers “911” was code for an urgent patient care need.) While in transit between patients without a cell phone, I would find the nearest pay phone to reply to the page. By the time a phone booth was successfully located, the person who generated the page would likely have left their desk to attend to another matter somewhere else in the office and this communication cycle would start again.
Paper documentation was completed to log the details of patient care. Photocopies of these notes were produced to build a “travel folder” to serve as a portable record. Unless I spoke directly with the nurse or social worker involved in the case or stopped by the medical records department to review the patient’s chart, there was no means of gleaning valuable clinical information about my patient without the physical documents in hand.
A new era of home health care has dawned, and at HCR technology is at the heart of operations becoming an irreplaceable necessity. Today we have touch screen tablets connected to a wireless network available 24/7. Clinicians maintain a full medical record on the device through our cutting edge, industry-leading software.
Through the tip of a finger swipe, the clinician can access the patient’s referral, physician orders, diagnosis list, medications, and visit notes completed by each member of the interdisciplinary care team. Internet access can be utilized to retrieve valuable community resources or health-related information for the patient.
Email alerts are readily apparent on the device, so each clinician can easily monitor and process information arriving from the office or fellow colleagues. Cell phones replace the old phone booths for field clinicians, allowing instantaneous communications on behalf of their patients. Now communication with the office from the field is easy, efficient, and effective.
The road to becoming an industry-leading provider has been paved with cutting-edge technology and skillfully navigated by the expertise and dedication of HCR employees. It is hard to imagine the barriers to quality care that once existed. Looking back, the good old days of home care weren’t actually that good after all.
posted on February 7, 2012
Carmen Camacho, RN, BSN
As we settle into February, which is Black History month, it is easy to reflect on many individuals from the past. In addition to our own ancestors, there are
others who stand out in our minds and have certain significance in our lives. For me, one such person is Mary Eliza Mahoney.
Mary was born in Massachusetts to Charles and Mary Jane. Early on Mary expressed an interest in nursing. At the New England Hospital for Women and Children Mary began her career in caring. Finally, in 1878, when Mary was thirty-three, she was admitted to the hospital’s nursing program.
Of the forty-two students admitted to the program, only four made it to graduation. One of the four, Mary received her certification on August 1, 1879, thereby taking her place in history as the first African American professional nurse in this country! Mary’s career spanned forty years and her patients had nothing but praise for the care she gave. Mary was one of the original members of the Nurses Associated Alumnae of the United States and Canada (later known as the American Nurses Association or ANA).
Mary died on January 4, 1926 after a three year battle with breast cancer. She is buried in Woodlawn Cemetery, in Everett Massachusetts. The National African American Nursing Sorority,
Chi Eta Phi , restored and maintains her gravesite. In 1973 they erected a monument to honor her life and accomplishments.
posted on February 3, 2012
Sue Bourne, RN, MSN - Directory of Specialty Programs
Today we are excited to announce the start of a new image-sharing process that we are piloting with three nurses (and hope to roll out to the rest of our nurses soon).
Formerly, the image-sharing process involved taking a digital camera to the client’s home (of which we only had four or five to share amongst all our field clinicians). Our nurses would then have to return the camera to the office so that a clinical support staff member could upload the pictures than either print or attempt to email to our wound care nurses or physician offices. What a hassle!
While in the field, nurses can use their Android device (that they use for documentation), to take pictures and then they can automatically send the picture on their device through HCR secured email to the wound care nurse team – essentially in one step! Now, our clinicians will be able take and share these images in real time. We have developed a protocol to provide guidance to you to ensure HIPAA compliance.
The WOCNs then attach the wound picture to the patient record and can print the picture as needed. We can also forward these images on to the client’s physicians just as securely and easily. Amazing! Physicians will get faster and more accurate updates on their patients and overall quality of care can be provided.
We are very thrilled to be able to use the latest technology to move our quality care and superior service to the next level of home care services. We look forward to what new advances still await us!
posted on January 25, 2012
Approximately 25% of people 75 years or older suffer from a condition known as low vision. Low vision can be caused by age-related eye changes such as reduced contrast sensitivity or an increased sensitivity to glare. The most common cause of low vision is the presence of age-related eye diseases such as macular degeneration, glaucoma, or diabetic retinopathy. Although vision loss may be permanent in many circumstances, skilled professionals such as Occupational Therapists can teach individuals with vision loss strategies to compensate for low vision, thus maximizing participation and independence in their daily tasks.
Most people desire to live independently in their own home as they age. Family members may have concerns about their loved one’s ability to live alone when he or she experiences vision loss. An Occupational Therapist can help by evaluating the home and making simple changes in an environment to assist the individual with low vision better manage daily tasks. Simple adaptations and strategies that an Occupation Therapist may use for people living at home with vision loss include: correct use of lighting, contrast, and augmenting lost vision with alternative sensory input.
Lighting is one of the most effective changes one can make to their homes and it is simple. Occupational Therapists ensure that available lighting is optimal for task performance. Lighting should evenly illuminate the environment or tasks being completed. The Occupational Therapist checks for shadows caused by light, as this can be visually confusing for a person with vision loss. When adding additional lighting, the Occupational Therapist ensures that the modification does not increase the presence of glare (e.g. light reflecting off of a shiny surface).
Occupational Therapists may use contrast as another simple, yet effective, modification to the home, allowing the individual to easily locate objects. When enhancing contrast, the Occupational Therapist places dark objects against lighter backgrounds, or vice versa. Examples of using contrast within the home would include the placement of bathing items in contrasting colored containers or the use of a dark place mat under light-colored plates to improve visibility.
People with low vision may instinctively rely on information that is received through hands and feet as their vision decreases. Occupational Therapists can help train those with vision loss how to enhance to attention this information and place tactile cues to promote safety and independence. One technique utilized by HCR Home Care Occupational Therapist, Jen Thompson, is the placement of velcro at the top and bottom of the stair rail, allowing those with vision loss to feel when they have reached the last step. This simple strategy may prevent an injury related to a fall within the home.
Making a home safer for those with vision loss does not need to be complicated or costly. Occupational Therapists have many useful adaptations and recommendations that can increase independence for those living with low vision. For more information, please call HCR Home Care and ask about our Low Vision program or submit a request for information here.
