Fulfilling Health Calls Mission One Relationship At A Time

Image


Health Calls received an unsolicited testimonial from a family this past week. It makes us so proud and speaks to Health Calls Mission.

‘Health Calls is a wonderful service! All of the nurses are of the highest quality and you really establish a relationship with them.

 

Health Calls is always available and ready to help no matter the time! I’d never use another agency with my mom’s care!

 

Congrats (to) everyone… associated with this fine organization!’

As invited guests in people’s homes, we must negotiate care. We cannot simply “do”. This is a shift in the perspective  that often accompanies health care provided in a hospital or other clinical settings. In those settings, the structure and processes require patients to adapt to the organization.

In home health, we are the guests.  The ‘house rules’ could get in the way. Instead, Health Calls staff is focused on teamwork, alongside other community professionals to treat patients where they live. This requires actively listening to the patient and family: finding out what is important, what can be negotiated, and then aid and inspire patients to become informed about their conditions and take an active role in their treatment.

The balance of power shifts away from the healthcare team to the individual and their family in a healthy partnership. We support the patient and family while they build skills, and foster their confidence to continue to lead active and fulfilling lives, long after our work
is done.

We are thankful to be invited!

Stand Up For Social Work

Image



Recently I had the experience of attending a specialty medical clinic with a family member and we were told one of the people we would be meeting with would be a social worker. An uncomfortable concern entered into mind. Why do we need a social worker? The need for a social worker’s help usually comes during difficulty or perhaps even an unpleasant encounter that will result in a life-changing event. In our situation, the purpose of a social worker was to introduce us to a world of information and support. With this information, we would never feel that we were alone with the new diagnosis. Social workers are champions.

The nation’s 650,000 social workers are champions for some of the most vulnerable people in our society. They stand up by comforting people who are experiencing devastating illnesses and mental health crises, ensuring they get best possible care while on the road to recovery. They stand up and support military personnel, veterans and their families, immigrants, people living with disabilities and people who are LGBTQ.

Child, family and school social workers stand up by protecting children who have been abused and neglected, helping children find new families through adoption, and ensuring young people reach their full academic and personal potential. And social workers work in communities and with national, state and local government to provide services and pass legislation to stand with and help people with the most needs.

Health Calls is fortunate to have three social workers on our team and while each of their roles are different, they are champions in helping our patients and families.

Sue Davidson,B.S. has medical social work experience and uses her skills as Health Calls referral liaison, making visits to patients at the bedside while in the hospital or rehab. She provides a bridge of knowledge and information for patients and families prior to the move back home. She educates the family about our services and educates them as well as making sure that the agency has as much information as possible to ease patients into a safe transition to home.

Aaron Rimby, B.S.W. also has medical social work experience and uses his skills to provide patients and families important information about their insurance benefit and any responsibilities that they might have for home health services. Since some Medicare Advantage and commercial insurance plans have co-pays, and patients may still have a financial deductible that needs to be met, hearing from Aaron prior to the first home health visit lessens anxieties ahead of the visit. Families are better prepared for the home health team’s first visit knowing and accepting any financial responsibility with Aaron’s communications. Aaron is frequently a communications bridge to the team. Aaron is a champion as he provides additional reinforcement to the information that Sue or another referral liaison may have already covered. Families are frequently in crisis mode and overwhelmed as they transition to home and Aaron adds a level of comfort along the path home.

Lillian Chinicci, M.S.W., L.S.W. is the agency’s medical social worker. Lillian provides home health visits to patients and families to support and advise, provides referral to community services and make recommendations to families about additional supports available. Lillian is a champion in her insight, knowledge of resources and her ability to facilitate communication between family members and to find common ground for stressed families in need of referrals to community services to help them.

 


Individually they stand up with their skill and expertise, making a positive impact for each individual family they encounter. Collectively, they stand up to strengthen the agency’s ability to meet the needs of all families Health Calls provides services to. Champions!

Happy Social Work Month! #SWMonth #SWStandUp http://www.socialworkmonth.org

Celebrate Certified Nurses!


Certified nurses are recognized for the value they bring to their specialty area of practice. On Sunday, March 19, we celebrate Certified Nurses Day.

The American Board of Nursing Specialties (ABNS), the organization that represents nearly a half million certified nurses states:

Specialty nursing certification is THE standard by which the public recognizes quality nursing care. With the increasingly complex patient/client needs within the current healthcare delivery system, care needs are best met when registered nurses, certified in specialty practice, provide nursing care.

Health Calls Home Health Agency Nurse Manager Cindy Dey, BSN RN CRRN, became certified in Rehabilitation Nursing in 1991. Cindy loves rehab nursing and teaching. She started her career working in neurotrauma at an Acute Rehabilitation Hospital. From the beginning, Cindy enjoyed working with patients and their families who needed to be independent with care in order to take their disabled family member out of the building on the grounds or even off-site for a therapeutic day pass, and to ultimately bring them home at discharge. Cindy became proficient and specialized in rehabilitation nursing knowledge and practice, taking the time to really focus on her patients – people suffering from head trauma.

When asked about her career choices, Cindy says,   “I took my career path seriously and wanted to be as proficient as possible with caring for Neurotrauma patients. In order to be certified, you must be experienced by working in rehabilitation for an extended period, and pass a written exam. The definition of rehabilitation nursing has grown and expanded over the years, and its principles of collaborative effort and team work are essential with nursing as a whole. Rehabilitation Nursing focuses on returning patients back to living optimal functional lives, although for some people it is a new normal. The goal is to get patients and the family unit to a functional, independent, active lifestyle. Rehab nurses focus on the whole person and not their  disability. It is something that I have a passion for, it has been the basis for my career in Home Health Nursing and also during my time teaching as an adjunct clinical nursing instructor.”

Cindy’s road to certification unfolded after her inpatient rehabilitation nursing job was completed. While many nurses become certified when working in an inpatient rehabilitation nursing setting, Cindy became certified once she found a home as a home health nurse. Since Rehabilitation Nursing is a specialty area practiced in many settings, Cindy was able to find so much relevance in her home health setting.

Today, Cindy is the On Call and Weekend Nurse Manager for Health Calls Home Health Agency, located in Wyomissing, PA. This job is a combination of many positions. Cindy is responsible for the after hour and weekend management of the agency. She takes all incoming telephone calls, which she proudly says come directly to her, as Health Calls does not have an answering service. “Our patients, nurses, therapists, referral sources, and the community get to talk to a live person, which is rare today.”

Cindy believes her firm rehab background has been very beneficial in Home Health Nursing. Traditional, site-based Rehabilitation Nursing teaches patients and their families about adapting and caring for themselves, or loved one, their health issues,  as well as preventing new problems.

“In a rehab facility there are no unusual structural obstacles or throw rugs, there are large spaces to lay out supplies for treatments and wound care, wide doorways, elevated toilets and handicapped safety railings, no stair cases or narrow hallways to navigate, to either get into your home or to get to your bed.”

“On the contrary, when patients are at home, they learn to adapt, navigate and work around pets, large pieces of furniture, and many obstacles. They learn how to care for themselves and regain their independence. The goals of Rehab Nursing and Home Health Nursing are the same: assessing, treating, assisting, teaching, and guiding patients in the transition back home, which is often a time of crisis. In all settings, rehabilitation nurses help patients and families make a paradigm shift and adapt from a time of dependence and illness to independence and wellness, or to manage with chronic illness, with the assistance of family or with the help of community services. We teach patients and families how to navigate through real life circumstances, and how to adapt to them, as well as who to reach out to in case of a problem”.

Cindy uses her specialty practice each day. Her typical day includes:

  • responding to critical vital signs in home tele-monitoring units the agency employs with patients with cardiac and respiratory problems,
  • taking calls from patients who are having medical problems,
  • responding to patient and family concerns and questions,
  • talking patients through medication schedule or dose questions,
  • trouble shooting medical problems or symptoms, and
  • problem-solving complex home care equipment with patients and families on the telephone.

Twenty-three years ago, Cindy met her husband, who had recently immigrated to the U.S. from Germany, on a blind date that her cousin set up. Cindy and Stefan have been married for 20 years and have three children: Summer, Jeremiah, and Danielle. Cindy’s 85 year-old mother also lives with the family. Cindy describes herself as chronically early; she hates to be late for anything. She is also a huge history buff and loves to travel. Cindy is the only child of a third generation dairy farmer and a self-professed country kind of girl. She graduated from Widener University.

Making Old Friends As People Achieve Home PT Goals

Image


 

Wendy Bergeman, PT, MS has been a physical therapist for over 25 years. She has provided physical therapy in many different settings including hospitals rehabs and outpatient clinics. She started working in home care about 15 years ago and knew on the first day that home care was where she was going to be able to make the most impact for her patients. Home care is a unique setting.

You get to see the patient in their own environment. They show you what is important to them and where they are struggling. Many times patients come home after doing well in rehab, but when they get home it all changes. Each house has its own challenges and the thrill for me and the patient is to work through those challenges and return the patient to independent living and enjoying life again.

The difference you see in these patients from the first day to discharge is amazing. On day 1 they are tired and weak —getting up and walking to the bathroom is a struggle. In a week or two they are taking care of themselves and then on the last day they meet you at the door with coffee and you feel like you are saying goodbye to an old friend. A lot of my patients feel like family by the time they are discharged.

image

Wendy Bergeman with her old friend, Mervin Lewis.

Health care is forever changing and today patients are coming home sicker and weaker since they are leaving the hospital faster. There is a huge need for these patients to get physical therapy. Many times without physical therapy, frail patients fail and end up back in the hospital or another type of facility. This is not only a huge cost to the healthcare system but can be devastating emotionally and physically to the patient.

Home physical therapy concentrates on building up strength and improving mobility but also focuses on making that patient safe and functional in their own home. The true goal of a home care physical therapist is to keep a patient in their own home for as long as possible, in the safest way possible. Sometimes this means getting adaptive equipment, making home renovations or hiring help.

This goal: keeping people safely at home, is what makes home care so fun. Each visit is different – somedays it is teaching a patient to get out of bed and other days it is showing them to how to safely take out the trash.

Safety is always the key and falls are always a concern in home care. Falls in the elderly are the leading cause of traumatic hospitalizations and a leading cause of death according to the National Council of Aging. About 25% of the elderly who fall and fracture a hip will die within 6 months and many more will never be able to return to their own homes again. Physical therapy can do a lot to help identify high risk fall issues and intervene to prevent fall injuries. “As home care therapists we stress the need for patients to stay active and safe,” Wendy says.

Wendy has been a member of the Health Calls team since 2013. When Wendy is not working for Health Calls Home Health Agency, she is busy at home. She lives with her husband and three kids- Katie – a senior at PSU, Rachel a Senior at Oley Valley High Cchool,and Richie, an 8th grader at the Oley Valley school district. She spends her weekends at PSU football games, watching Rachel in horse competitions or Richie in sporting events.

When Parents Don’t Want an Advocate: A Caregiver’s Dilemma


Giving up independence temporarily while working to get stronger will improve quality of life.Giving up independence temporarily while working to get stronger will improve quality of life.

 

One morning last month, a registered nurse in my office received a phone call from “Mickey” who was interested in referring her father for home health services. Her dad, an 83 year old man whom we will refer to as “Bill” had been in the hospital recently.

Bill was pretty sick when he was admitted. He spent time in Intensive Care and was treated with IV antibiotics for septic shock due to an infection of a non-healing wound on his leg. He was very lucky to recover.

Mickey did her best to advocate for her dad while he was receiving treatment in the hospital. She asked that he be referred to a rehab hospital to recuperate for a short time after his hospital stay. He had been in bed for 5 days and she was afraid he was too weak and might fall if he went straight home. Since Bill passed the walking test with the physical therapist he wasn’t a candidate for inpatient rehab. Mickey asked for home health to come visit her dad at home but Bill refused.

“I don’t need help,” Bill protested. While Mickey tried to advocate for her father, the hospital failed to consider that her father might have limited idea into his real needs at discharge and the discharge planner didn’t ask his daughter to verify the information he provided.

Mickey told me that even before spending 5 days deathly ill in the hospital, he needed help with the simplest of tasks at home. When Bill went home, Mickey and her mother did their best to help her dad settle in safely at home. Mickey works full time and her mom has health problems of her own. Now, Mickey was completely overwhelmed as she tried her best to hold things together juggling her job, her own home and her parents’ needs. She noticed that her dad was now short of breath with the most minimal activity, like putting on his shirt.

Mickey waited the long week to her dad’s follow-up doctor appointments. Finally, with the audience of the doctor, Mickey shared that things weren’t going well at home and asked some difficult questions. Wound care orders were never provided when Bill had outpatient surgery in the weeks before his hospital stay. While the doctor admitted he didn’t provide the right instructions, he never admitted he was wrong. The doctor insisted that her 83 year old father was capable of doing his own wound care, even after the hospital admission due to infection.

That same day, the family visited the family doctor. At this visit, Mickey laid out the hospital stay, how poorly things were going at home and revealed some of her own stress in trying to hold it all together. This time she came away with orders for home therapy and nursing visits. Mickey tells me:

People are going to say no because they are proud. My dad was really struggling at home so he was finally open to receiving help. The nurse and therapists were no longer strangers. These were people who took time to make a personal connection and so my parents were open to their visits. They were helpful without being bossy.

Bill allowed the nurse and therapists to visit, they formed a bond. Bill and his wife committed to the agency’s home equipment and safety recommendations, allowed these former strangers in to treat his wound, and provide therapy to make him stronger. Bill was back to his personal best in 3 weeks.

“What do people do if they don’t have somebody?” Mickey asks. Mickey believes this whole experience has helped reshape her caring relationship with her parents. She feels empowered. In the past, her parents would go to the doctor’s office and she would ask questions about the outcome and get vague answers. They weren’t being evasive; its hard to remember and the experience is overwhelming when you are the patient in the “hot seat”. Instructions provided by health care providers can get watered down in translation while trying to capture everything that’s been recommended. Mickey now realizes these types of errors and omitting important recommendations often lead to hospital admissions.

Now, Mickey goes along to keep notes, and to ask the important questions, understand and follow through on treatment. Fortunately, her parents now see that she has helped them and view her as more credible.

Mickey says the real turning point came when she said to her dad: “You have 2 choices. You can be a grumpy, unhappy old man who has to depend on others to live your life or you can be pleasant and appreciative while Mom and I care. We are not taking your independence away; we are helping you so you can get your independence back. You need to give it up, and work to get stronger, so you can get your independence back”.

Health Calls Home Health Agency recognizes and honors the 39.8 million adults caregivers (2015 Report Caregiving in the U.S. research report conducted by AARP and the National Alliance for Caregiving)  in the United States.

Rehabilitation Matters For Stroke Recovery


The American Heart Association and the American Stroke Association released new guidelines for Adult Stroke Rehabilitation and Recovery. These have recently been released in the professional journal “Stroke” (May 2016). The joint organizational guidelines recommend that, for the best outcome, stroke patients who require rehabilitation following a hospital stay should receive these services in an Inpatient Rehabilitation Facility.

Inpatient Rehabilitation Facilities are considered acute rehabilitation care and are not nursing homes.

As I mentioned in my post Do You Have A Choice?, you have the right to know treatment options and to take part in decisions about your care for yourself or a family member.

The Resource: Making the Right Decision For Rehabilitation Care is an excellent resource describing the difference in settings for rehab services and care.

The American Heart Association and The American Stroke Association also recommended that stroke patients not be discharged from the hospital until they have taken part in a structured fall-prevention program. It should include home safety measures like removing throw rugs and improving lighting, minimizing the fall risk that results from the side effects of medication and training in the safe use of wheelchairs, walkers and canes.

While families may not find that these recommendations may be acted upon by rehabilitation hospitals prior to discharge (depending on the resources available to complete home evaluations with the patient prior to discharged), a home health agency providing stroke rehabilitation should complete a home safety evaluation as part of the home rehabilitation program.

The National Institute of Health offers home safety tips to prevent falls.These general guidelines are customized to the unique needs of someone who has had a stroke to prevent falls and other injuries by the home health agency providing at-home stroke rehabilitation following an inpatient treatment program.