Adult Diaper Rash - How to Reduce the Redness and Heal the Skin

It is difficult for an adult to deal with the need to wear diapers. Often, problems of incontinence are kept a secret from family members for a while. Once this is out in the open with family members, the next hurdle can be how to deal with adult diaper rash. Not everyone gets diaper rash, but depending on one's illness, lifestyle , allergies and hygiene this problem can occur. If one is in bed most of the day this can also complicate the problem.

One can wear diapers as an adult both due to bed wetting, urinary incontinence, urinary infections, leakage and fecal incontinence. If one is in an assisted living facility or nursing home, the staff should be taking care of this problem. An adult diaper rash can be small pimples, larger sores or red patches.

It's important to frequently change the diaper because the skin gets irritated by urine and fecal material and this leads to a rash often. Ideally it is best to change the diaper as soon after it is soiled as possible. However, due to one's sleep routines, degree of disability, hours of hired help and other factors this isn't always possible. If there is a rash, frequent changing of the diaper, stronger diaper materials that absorb dampness plus applying effective lotions on the skin are important to heal the skin.

At the assisted living facility I work at, one client complained of her diaper being too tight on her body. It is important to be sure that it is adjusted properly. If the diaper is tight and the body heats up then this can make the problem more severe. Urine is acidic and having this trapped is not healthy. If you are taking care of someone or hire help, be sure that they let the body dry off when the diaper is removed. Be aware when you are wiping whether there is an issue with the alcohol in some wipes.

Over the counter diaper rashes are effective. Some people prefer Vitamin A and D ointments and others find applying dry cornstarch useful for drying up the red diaper rash and sores. Check for allergies as well as certain foods can create a rash in the sensitive areas of the body.

Be sensitive to the adult your are helping with the issue. There is often a sense of shame. Assure the person that it is very common and not to beat themselves up about it. Show your care and use humor to diffuse a negative mood so you can uplift the person in your life.

Fall Prevention for the Elderly

Methods of preventing falls in the elderly have improved greatly over the years, and technology and fall management strategies in hospitals and nursing homes have all contributed to improve care of patients, residents and family members at risk of a fall.

One of the main improvements in technology has been to give carers and nurses "advanced warning" when there is a risk of a fall. This is commonly when a person at risk of falling leaves their bed or chair. The latest bed sensor mats and chair sensors are able to alert the carer or nursing staff or indeed warn the person themselves to stay where they are until assistance arrives.

The elderly in particular can be at risk of falling for a variety of reasons including cognitive problems, restricted mobility, loss of balance, dizziness, medication and muscle weakness for example.

So when you need to be alerted to the risk of a fall, what are your options? Here we quickly summarise the products available that should be of interest:

Bed Sensor Mats - a mat is placed in the bed under the sheets or under the mattress. The bed mat is connected to an alarm which is activated when the mat detects that the person is about to leave the bed. There are several alarm options:

A friendly voice reminder can be played, such as: "stay in bed John, I'm on my way". A friendly voice is particularly helpful when someone is confused, especially when they awake during the night, and a friendly voice is reassuring. The sensor mat detects if the person has not returned to bed and will play the reminder a second time. If they still do not return to bed the carer is alerted.

An alternative version will sound an alarm only to notify nearby staff/carers to attend. A light also flashes to help with identifying who's alarm has been activated in a multi-occupancy room.

A third version will connect to a nurse call system and alert staff via their monitoring system. In this case the room monitor can be set to silent if preferred to avoid noise in a shared room.

Chair Sensor mats - as above, the chair sensor mat is placed in a chair or wheel chair and detects when a person is about to leave their chair. The same alarm
options described above also apply.

Fall prevention has many options and all our bed sensor mats, chair sensor mats and monitors are interchangeable so you can tailor your requirements -
whether you are a hospital or nursing home or a home carer.

For further advice, please talk to one of our fall prevention specialists on 1890 344 344 or email info@homecaretechnologies.com.

Nursing Home Alert Number One

Every single day, in some rehabilitation and care centers and in some nursing homes, patients are being permitted to develop bedsores on their bodies due to lack of care and negligence. Every doctor knows that to avoid and prevent bedsores, you must turn or move a patient at least once every two hours. Yet in some of the nursing homes where the care is lacking, patients are allowed to sit and lay in one position for up to six or seven hours each and every day and then the same in the nighttime. You can prevent this from happening to someone that you love by just knowing this information and by doing what you can to make sure that patients in all facilities are being taken care of.

I urge you to be very careful in choosing a rehabilitation and care center.

I urge you to be careful in choosing nursing homes. And if at all possible, try to keep yourself at home instead of resorting to using any of these corporations in your life. Every human would probably be better off in their own homes rather than residing in rehab and care centers and in nursing homes. Yes, there are some good ones, but there are some horrible ones. It is up to you to distinguish which is which one.

The following article is for your information. If you need professional help, contact a lawyer, counselor, or doctor immediately.

First ,a little background and information about nursing homes and rehab centers: Nursing homes and physical rehabilitation centers are in a world of their own. And when you find the ones that are extremely focused on security so much that you feel like you are in a concentration camp and not in a nursing home, then you know that something is very wrong in that facility. I have learned from experience, from visiting patients and residents inside of various nursing homes and rehabilitation centers that the good nursing homes feel like that, like homes, while the bad nursing homes feel like you are in a war and you are the prisoner. Go with your feelings. If you are evaluating nursing homes and rehab centers, go with your feelings. Your feelings are true. If you feel that something is wrong but you cannot immediately put your finger on what is wrong, listen to your inner instinct, and search for a better nursing home or rehab center. The world is not all harmful. Trust that there are nursing homes that actually take good care of people. You just need to be diligent, focused and persistent in your evaluations of these places.

SO, what would you look for if you were looking for a good nursing home?

Try beginning here:

1. Peace, quietness with activity, cleanliness and orderliness.
   
   
   
   


2. Adequate room, space, recreation activities and appropriate therapy, equipment, tools and staff.
   
   
   
   


3. Advertisements, brochures, research and background & word of mouth reputation

Peace, quietness with activity, cleanliness and orderliness (These is what I saw when I visited the nursing home that actually takes care of their patients and residents)

Peace, quietness with activity and cleanliness and orderliness are priorities when searching out a great place to live or temporary visit. If you walk in and you feel peaceful, then you know the place is doing it's job. The peace that you should experience is not a "twilight" zone peacefulness where you hear no sound and see no people, but a peacefulness where you see the hub-bub of what's happening around.

In the good place, there were always relatives, friends, and even young people visiting. There was consistent and daily visitors and good activities. As opposed to the bad nursing home, where most of the activities were staff trying to keep residents in bed, and away from visitors.

If you walk into a place and see people arguing constantly or if you see someone having fits in the lobby and it appears to be a regular thing, you might need to look elsewhere for your nursing home or physical rehabilitation center. Cleanliness is of the utmost importance, so notice how the place looks. Notice if you are on one of the upper floors if there is dirty clothing around or soiled linens in the hallways. These are small signs that something is wrong. Notice if many of the residents or patients are complaining that their clothing is "lost" or that clothing doesn't seem to come back from the laundry at that place. These are all things to notice if you are going to do an appropriate evaluation of any facility.

Orderliness , yes notice that. Is everyone "losing" things? Are many patients or staff complaining that something is always "missing"? These are things to note and things to take into consideration when checking out a nursing home. Orderliness is a sign that things are possibly going okay but always thoroughly check out the physical rehabilitation place or the nursing home and keep checking it out until you are satisfied that you have seen everything that you need to see. Never choose a place in haste.

Adequate room, space, recreation activities, tools and staff:

Adequate room, space and recreation activities are very important in these facilities, nursing homes and physical rehabilitation centers. Are you looking around and seeing overcrowded rooms? Are you seeing tons of wheelchairs all over the hallways but not seeing enough staff attending to those who need help?

Are you seeing residents and patients crying or yelling for help but the staff appears to be ignoring those pleas for help? Notice whatever you see, and make note s in your small notebook. You will not remember everything by member, so do not rely on that. Just write it all down.

Appropriate therapy equipment and tools:

Look for the physical therapy room. Have a tour of the entire place before committing to any admission to the facility. Specifically ask to see the physical therapy room if you are there for therapy. How is the equipment stored and maintained? Is the equipment clean? Is there enough equipment?

What about special equipment that is needed for patients and residents who have special needs? Are there "amputee" walkers in the therapy room or do the amputees have to hop around like a frog in order to get from one place to another in the physical therapy room. Are there crutches in the room but the personnel refuses to train the residents on the crutches? Are staff and personnel too occupied with being worried about liability rather than being occupied with helping, aiding and giving proper treatment and care to new patients?

Try and look at the therapy room when it is "full" -usually early in the morning or early afternoon. How many residents are in the room? How many are actually doing therapy? How long do residents "wait" for their therapy; how long do they just sit and sit and sit during the day, and during the pre-therapy sessions?

Ask your regular family doctor what kind of therapy or what kind of care that the patient needs. If you have discovered that you are in one of the horrible nursing homes, find your own doctor, and do not rely on their own doctors. II learned this too late; but you are now informed about what would be most helpful to you. Do not rely on "their " doctors but have your own if you are able to afford that.

Advertisements, fancy brochures, research and background and word of mouth reputation:

Know that word of mouth reputation is probably more important than advertising and brochures. You need to know which residents used to go there and how they liked the care that they received there. You need to hear that from impartial people, not from staff, personnel or doctors. Research . Go online and see if this place is on the list of the WORST nursing homes in the country. But, do not relax too soon. EVEN if this place is not on the list, that doesn't mean that it is not a bad place. All that means is that it is not on the list YET.

Advertisements: : When the advertisement looks as if it is describing a totally different facility, that might be false advertising , so be aware of these things. Does the advertisement say there is a pool, yet there is no pool? When you ask to see it are you told, "it is under construction" -- yet, the advertisement or brochure makes it "appear" as if the pool is there already and ready for use or in use already. Does the advertisement offer a solarium or private rooms, when there clearly are no solarium or private rooms available. Does the brochure offer MUCH but the facility offers little? These are warning signs. These are signs to look for.

So do your homework, your research and your observations before committing to enroll anyone in any physical rehabilitation center or in any nursing home.

Google the name of the nursing home or rehabilitation center. See what comes up.

Check with your consumer affairs agencies and with your Better Business Bureaus. Even though this is a nursing home, you still might be able to check with the Better Business Bureau to find out what kind of customer service policy they have or to find out if there are any previous complaints against this nursing home or physical rehabilitation center.

Look Around You:

See everything that you can see. If possible , visit the place more than once before you do any admissions of patients or relatives.

Listen to those around you. Yes, listen. As residents and patients and families pass you by in the hallways, listen to the conversations that they are having . You will be surprised at what you hear when you listen to other conversations in the hallways of the nursing homes and physical rehabilitation centers.

See if you can get a tour of the upper floors in any facility. This is usually where they "hide" residents that they do not want the public to see. So, if you are visiting and evaluating a nursing home or a physical rehabilitation center, make sure to see the upper floors. You can find a staff person to give the tour.

By listening, you will get the most important information about the place that you will need. As you walk by someone who is walking in the hallways , you might "hear" that a resident was missing for a while, or that a resident walked out of the facility, or that a resident keeps trying to leave the nursing home or physical rehabilitation center. Listen carefully. You will learn about the facility, about the residents, doctors and everything related to staying in that facility.

You might go online and find some nursing home blogs that are not affiliated with the nursing homes (sometimes residents and patients can do some blogs in some nursing homes). You can join in there and do some observations, and perhaps, who knows, perhaps you can start a residents or patients group online.

Whatever you do, your key are these things:

• Listen.
  
  
  
  


• Hear.
  
  
  
  


• Observe.
  
  
  
  


• Note.
  
  
  
  


• Observe more and again.
  
  
  
  


• Listen more carefully.
  
  
  
  


• Connect.
  
  
  
  


• Stay connected.

Doing these things and making these your first priority when choosing a rehabilitation center or nursing home, will give you the best advantage and will give you good choices.So, this article has listed and explained some of the best things that you can do to make sure that your choice of nursing homes or rehabilitation centers are best. But also, this article and all the ideas inside this article are equally important AFTER you have made the choice and after you have already gone through the admission process. Always keep your ears and eyes open. You can't go wrong by doing that. Warning Signs:

There are some warning signs that you should be leery of if you happen to see them or experience them in any physical rehabilitation and care centers and nursing homes. These are some of the warning signs:

• Filth -- Is there dirty clothing all around on the floors or in the hallway? Are the floors sticky or dirty? Does the room or corridor smell or have nasty odors?
  
  
  
  


• Overcrowding -- Do you see wheelchair after wheelchair after wheelchair - waiting for long periods of time to get upstairs or downstairs on the elevators? Are the rooms overcrowded ? Is the rehab center or nursing home overcrowded? What do the fire regulations say?
  
  
  
  


• Noise Pollution -- Is there loud music playing all the time? (Is this a cover-up for the "noises" that the staff doesn't want you to hear)?
  
  
  
  


• Lost Clothing - Losing clothing is one thing, but are you in a facility that constantly loses most of your clothing? Are residents and patients in the long-term units constantly wearing other people's clothing? Are there residents or patients lying naked or half-naked in their beds due to lost clothing? These are huge red-flags for you to look for.
  
  
  
  


• Oppression - Do the residents seem frightened or scared? Are the residents afraid to complain about anything? Or when they do complain are they ignored as if they are invisible or are they punished for complaining? Are family members punished for complaining?
  
  
  
  


• Staff who is never "available" but they suggest that you "ask someone else" , then you are given the run-around. Huge red-flag here.
  
  
  
  


• Inadequate smoke alarms, and inadequate fire drill preparations and lack of emergency evacuation instructions.
  
  
  
  


• Mislabeling of important things in the facility. (This will be explained in another article).

Most places are not like these (listed above) but we still need to be aware so that we can distinguish the good from the bad. So keep your ears and eyes open , always and spread the word!

There are so many other ways to almost guarantee a pleasant stay at a nursing home or physical rehabilitation center, but this is just a beginning.

Update: Recently I have been able to visit a nursing home center that is a nice place for humans to stay. This nursing home is in Brooklyn, NY. The difference between this one and the other one is like night and day . It gives everyone hope knowing that there are some places where life goes on the way it should. There are some places that have professionals workers and that have enough so that each resident and patient are treated with respect, and good care.

When you visit nursing homes or rehab centers -to inspect them, make sure you see the long-term floors and the floors where people actually are living in . Listen to your inner instincts. If something is telling you that something is wrong; you are most likely correct and something is wrong. Do what is best and right for you.

The nursing home and care center that gave me nightmares (due to conditions and due to how residents are treated and taken care of) is in Staten Island, New York. I still have nightmares sometimes over what I saw inside of that nursing home. I hope that no one has to go there ever. If I had a pet that needed care, I would not send that pet to the home in Staten Island. The nightmares were relentless and they are finally letting up.

UPDATE: Sometimes it seems as if it is very hard to get out of a nursing home. It seems that way because it is that way. There is so much red tape and so much paperwork and pre-discharge items to handle. If you are in a nursing home and have no family and friends to visit you, you will find that the red tape is doubled and you will find yourself that you might feel like you are a prisoner in that home. Try and seek outside help. Write a letter to your assemblyman or congressman if you are feeling that you are being held against your will at any medical facility or rehabilitation and care center.

Updated May 04, 2008

Nursing Home Facilities - Top 10 Myths

Myth #1: Nursing facilities smell bad.
Reality: Most good facilities rarely smell bad, and when they do, chances are, it will be taken care of promptly. Not only are nursing homes inspected by each State on behalf of the Medicare administration every twelve to fifteen months, but they are also inspected by family members and other health professionals, albeit more informally, on a regular basis. So while you may encounter an unpleasant odor on one visit, it's likely you may never experience it on subsequent visits. If you do, take it up with the administrator. Nursing home administrators are typically very sensitive to this issue and will take action quickly.

Myth #2: Nursing home facilities are like hospitals.
Reality: Nursing homes are residential facilities that provide medical care, but they are not like hospitals. The environment is much less clinical, for one thing. In addition, community living has a much different feel than a temporary stay in a hospital. Nursing homes offer activities to keep residents engaged in the community, and interacting with one another. And as neighbors, residents often form lasting friendships.

Myth #3: The people who live in nursing home facilities are all dying.
Reality: Nursing homes provide continuous medical care for people whose medical conditions require around-the-clock care or monitoring. While it is true that some elderly and terminally ill residents may be dying, at that point they are certified by their doctor to receive hospice (i.e., end-of-life) care, and that is certainly not the case for all residents. Many nursing home residents simply need a higher level of care than is available at an assisted living facility.

Myth #4: All nursing facilities are the same.
Reality: This couldn't be farther from the truth. It is important to carefully research the facilities you are considering, because despite stringent federal regulation, all facilities are different. This can be a wonderful thing-for example, when it creates a strong sense of community among residents-but it can also have a down side, especially when a facility does not address problems that affect residents' quality of life and/or quality of care.

Myth #5: Caregivers can use restraints to control residents.
Reality: Restraints may only be used when it is medically necessary for a resident's safety or the safety of others. It is unlawful for facilities to administer physical or chemical restraints for any other purpose.

Myth #6: Insurance will pay for my nursing home care.
Reality: It depends on the type of coverage you have. Many people are surprised to learn that Medicare only pays for 100 days of nursing home care per illness, and prior to that, you must meet a number of requirements before you are eligible for benefits. Also, only the first 20 days are covered in full; the rest requires a significant co-payment ($133.50 per day in 2009). After that point, you are responsible for paying for expenses out of pocket until you become eligible for Medicaid. Some long-term care insurance policies provide coverage in a nursing home facility, but not all. If you have a long-term care insurance policy that provides nursing home coverage, check your policy to determine your coverage limits and restrictions.

Myth #7: There is no privacy in a nursing facility.
Reality: It's true that there is typically less privacy in a nursing facility than in other types of senior housing. Most rooms are shared by two residents, and caregivers may enter the room as needed-visitors, too, as desired. However, nursing homes are required to maintain a private area for visits with family, and most facilities try to respect residents' privacy as much as is possible. Residents have the right to privacy, and to keep personal belongings and property as long as they don't interfere with the rights, health or safety of others.

Myth #8: Nursing facility residents have limited rights.
Reality: Residents retain all of their legal rights once they move in. In addition, Medicare has established a Nursing Home Residents' Bill of Rights that clearly defines residents' rights pertaining to: respect; services and fees; money; privacy; and medical care.

Myth #9: A move to a nursing facility is a permanent move.
Reality: Most nursing homes have wings for both long-term care and short-term care. The long-term care wing is for residents, while the short-term care wing houses people who are recovering from an illness, injury or surgery and require rehabilitation. So while a move to a nursing home facility may be permanent for some people, many others return home once they have sufficiently recovered.

Myth #10: Nursing facility residents are always on caregivers' schedules.
Reality: It's true that a structured schedule can enable caregivers to do their jobs in the most efficient manner possible. However, more and more rest homes are recognizing the need to address residents' needs in a more holistic manner, and in a way that honors their dignity and preferences. This includes empowering residents with more options and autonomy in setting their own schedules.

Picking the Perfect Nursing Home

If you are in the process of looking for a nursing home for a loved one you will want to find the best possible care available. It can be a trying time when you have to watch a loved one be re-located to a nursing home so it is reassuring to know that you have done your part and looked in detail for high quality care. Empower yourself and your family member by taking the time and effort to research all of the homes available to you. This is a rough guide to help make this process slightly easier.

The first thing to do is to research homes in your area or the area you wish your loved one to be re-located to. This can be done via the internet or using the phonebook and you should look to shortlist at least five or six nursing homes to further research.

Once you have taken the time to research and short-list some nursing homes the next step is to call each of the homes and arrange a tour. One useful tip is to listen carefully to the person's voice who answers the phone, take into account their tone and demeanour as this could be a first indication of what the quality of service will be like. Whilst on the phone take time to ask question and be specific. Ask all of the questions you can think of whether they are about the various medical suppliers the home uses or about the available recreational activities for the patients.

When you arrive for your tours of the various homes make sure aware of your first impression, is it airy, clean and bright? You need to assess the atmosphere and best judge whether your family member will be happy staying in the home. Also take into account all of the little details. What is the hospital furniture like? Ask about the equipment, if they mention something you don't know about like bp monitors then you should ask. One of the most important things to do on a tour of a nursing home is to use your own eyes and ears, the tour guide will only tell you how wonderful the home is so you must be on the lookout for negatives. This is not to say that you should go on the tour with a negative outlook you should just keep your eyes open for anything that does not look good. Also remember to ask for an information package about the home, this will help to further research the home.

Whilst you can receive all the advice in the world about looking for the perfect nursing home nothing will compare to your own instinct. Always keep in mind that your loved one will be living in the home you choose and this will ensure that you pick the best possible option for you and your family.

Being a Nurse - Its Benefits and an Overview of What They Do

The current financial crisis makes it difficult to survive for a lot of us. For the most part, we find ourselves overwhelmed by one financial problem after the other. As such, we couldn't help but ask ourselves what kind of career will give us a stable source of income and a better life for us or our families?

Well, you might be surprised that the answer to that question is more obvious that you think: being a nurse. At this time, nurses are one the most in-demand workers in the health industry. There are approximately 2.4 million job openings for nurses right now, and to fill this need, hospitals and the like are offering competitive salary, benefits, and compensation package.

There are a lot of opportunities for personal growth and development in nursing. Specialization in specific nursing fields is an alternative which nurses can take advantage of not just in hospitals, but even in medical clinics, outpatient centres, nursing care facilities, and geriatric facilities.

With a wide array of work places that offer career development, nurses would practically never run out jobs. Also, this kind of advantage makes nurses competent enough to work even in other parts of the globe.

Aside from the popularity of nurses nowadays, nursing is one of the very few careers which will never go passé. Like doctors, there will always be a need for nurses. Also, there are several types of job opportunities in the field of nursing. In the Unites States alone, there is currently a need for approximately 100,000 nurses, and experts say that this figure may triple over the years. With incentives like these, who could say no to such a promising career?

Registered Nurse (RN) - Background of their Duties and Responsibilities

The duties and responsibilities of a registered nurse can change from every state and institution. Laws on a RN's scope of practice vary in each state. Different institutions also have varying guidelines for the scope of practice of the nurses and medical professionals they handle. At times, these guidelines are even more restrictive than that of state laws.

To help an RN determine whether something is within the scope of their profession, some states have devised the following questions which RN's can ask themselves:

1. Is it allowed by the nurse practice act of the state you are working in?

2) Is the skill something you learned in your basic nursing education or in any additional training program you've attended, including clinical training?

3) Can you find the procedure in the policy manual of the institution you are working for?

4) Is the task in conformity to the "Prudent and Reasonable" standard for nursing?

If after asking these questions a nurse is still unsure whether a task is included in their scope of practice, he or she can get clarification from their state nursing board.

Evaluating a person's health and devising an appropriate health plan is one of main duties of an RN. Normally, RN's coordinate with other health care professionals in giving individuals under their supervision suitable health care and education.

However, as mentioned before, the regulations in each state differ. As such, it is wise to always consult the nursing laws in the state where a nurse is working to verify if a particular task is within a RN's scope of practice. A RN should also check the policy and guidelines of the institution they are working for, to ensure that what they are doing is within the areas of responsibility allowed by that institution.

LPN (Licensed Practical Nurse) - Playing an Important Role in the Healthcare Industry

A Licensed Practical Nurse (LPN) or Licensed Vocational Nurse in the state of Texas and California, assists RNs and give patients a more personal level of attention.

Although LPN's are normally supervised by physicians and RNs, their responsibilities increase as their gain more knowledge and experience.

Some LPNs already take on tasks such as taking vital signs, monitoring in and out volumes, turning patients to avoid bedsores, treating and/or dressing wounds, providing enemas and more.

LPNs also take care of simple duties like getting measurements (height, weight, temperature, blood pressure, pulse rate, etc.), giving alcohol rubs, assisting patients take care of their personal hygiene, and most of all, offering the patients a friendly face and a caring heart as they walk the road to recovery.

LPNs are the ones responsible for the day to day care of patients. They give patients a more intimate and hands on attention, which RNs are no longer able to provide due to their busy schedule.

In some states, LPNs are allowed to administer prescribed medicines and starting IVs. On other states however, such tasks are not part of their responsibilities. LPNs also need to spend time with the family of the patient and teach them how to take care of their loved one, especially once they continue their recuperation at home. The LPNs provide the patient's family with all the information they need to take care of the patient once they've been discharged.

Due to the variations of state regulations, it is hard to give a definite job description for a LPN. Some states even allow LPNs to assist with the delivery, care, and feeding of a newborn.

For the most part, the work of LPNs covers various fields of medicine and healthcare. As such, there are also LPNs who work in nursing homes, medical offices, or private homes.

Healthcare facilities like nursing homes certainly benefit from the services of LPNs, as they are able to asses residents, supervise nursing aides, and develop basic healthcare plans. In a doctor's clinic, a LPN takes care of setting appointments, filing medical records, and other administrative functions.

LPNs are very important to the smooth flow of the health care profession. RNs and NPs will definitely have a harder time with their jobs without LPNs.

Although the general scope of practice of LPNs is apparent, the extent of what they can perform will vary depending on their place of work.

As you think of starting a career in nursing, it is important to note that although doctors and administrators may be on top of the list, nurses and LPNs are definitely the heart and soul of the healthcare industry.

Hiring a Home Health Care Employee

 Providing the primary care for an elder loved one can be difficult. When you cannot deliver all the elder care yourself and support from friends, family, and community organizations is not enough, it may be useful to hire a home health care worker. He or she can offer care from a few hours a week to 24 hours a day, and can provide many other helpful services. Types of in-home health care services include:

• General Health Management like administration of medication or other medical treatments


• Personal care such as bathing, oral hygiene, dressing, and shaving


• Nutrition help like preparing meals, assisting eating, and grocery shopping


• Homemaking services including laundry, dishwashing, and light housework


• Companionship for example reading to the senior or taking them on walks

Recruiting and Interviewing Applicants

There are many avenues for hiring a home health care employee. Generally, home health care workers can be hired directly or through an agency. Home health care agencies often have a staff that includes social workers and nurses that will manage your care. However hiring an independent home health care worker is generally more cost effective, it will also give you more control over the type of care you receive. 

Senior home care workers should be carefully screened for proper training, qualifications, and temperament. Fully discuss the needs of the elder care recipient during an interview with a prospective home health care employee.  There should be a written copy the job description and the type of experience you are looking for.

References

Have applicants fill out an employment form that includes the following information:

• Full name


• Address


• Phone number


• Date of birth


• Social Security number


• Educational background


• Work history 

Before hiring, you should ask to see the senior home care worker's licenses and certificates, if applicable, and personal identification including their social security card, driver's license, or photo ID. 

References should be checked out thoroughly.  Prospective employees should provide the employer with names, dates of employment, and phone numbers of previous employers and how to contact them.  It is best to talk directly to previous employers, rather than just to accept letters of recommendations. Also ask the applicant to provide or sign off on conducting a criminal background check 

Special Points to Consider

Make sure the person you are considering hiring knows how to carry out the tasks the elder care recipient requires, such as transferring the senior to and from a wheelchair or bed.  Training may be available, but make sure the worker completes the training successfully before hiring him or her.

No one should be hired on a seven-day-a-week basis.  Even the most dedicated employee will soon burn out.  All employees need some time to take care of their personal needs.  No worker should be on call 24-hours a day.  If the elder care recipient needs frequent supervision or care during the night, a family member or second home health care worker should be able to help out or fill in.

Live-in assistance may seem to be more convenient and economic than hourly or per-day employees but there can be drawbacks.  Food and lodging costs must be calculated into the total cost of care, and it could be difficult to dismiss someone without immediate housing alternatives.  If you decide to utilize a live-in arrangement, the employee should have his own living quarters, free time, and ample sleep.

Job Expectations and Considerations

Before hiring a senior home health care worker, you should go over the tasks you expect them to perform and other issues, such as promptness, benefits, pay scale, holidays, vacations, absences, and notification time needed for either employer or employee before employment is terminated. If you work and are heavily dependent on the home health care worker, emphasize the importance of being informed as soon as possible if he or she is going to be late or absent so that you can make alternative arrangements. Be clear about notification needed for time off, or what to do in the case the home health care worker experiences a personal emergency that requires them to abruptly leave work.  It is important to have a backup list of friends, family, other home care workers, or a home health care agency you can call on.

Be clear about issues concerning salary, payment schedule, and reimbursement or petty cash funds for out of pocket expenses.  

You should spend the day with the home health care worker on his first day to make sure you are both in agreement over how to carry out daily tasks.  It would also be helpful to supply the home health care worker with a list of information on the elder care recipient such as: special diets, likes, dislikes, mobility problems, health issues, danger signs to monitor, possible behavior problems and accompanying coping strategies, medication schedule, therapeutic exercises, eye glasses, dentures, and any prosthetics. 

You should also provide the following information to your home health care worker: your contact information, emergency contacts, security precautions and access to keys, clothing, and locations of washing/cleaning supplies, medical supplies, light bulbs, flashlights, fuse box, and other important household items.

Transportation

Another big consideration in hiring a senior home care worker is how he or she is going to get to work.  If they do not have a reliable car or access to public transit, then you might want to consider hiring someone to drive him or her, which might be more economical than using taxis.  Inform your insurance company if the home health care worker is going to drive your car when caring for the senior.  Your insurance company will perform the necessary driving background checks.  If the home health care worker is using his or her car to drive the elder care recipient, then discuss use of her or his car, and conduct a driving background check.

Insurance and Payroll

Check with an insurance company about the proper coverage for a worker in your home.

Make sure all the proper taxes are being drawn from the employee's check by contacting the Internal Revenue Service, state treasury department, social security, and the labor department.  If you do not want to deal with the complexities of the payroll withholdings yourself, than you can hire a payroll company for a fee.

Even if your home health care worker is working as a contractor, you are still obligated to report the earnings to the IRS.  Talk to your accountant or financial adviser about making sure you are following IRS rules.

Ensuring Security

You should protect your private papers and valuables in a locked file cabinet, safe deposit box, or safe. If you are unable to pick up your mail on a daily basis, have someone you trust do it, or have it sent to a post box. You should check the phone bill for unusual items or unauthorized calls. You should put a block on your phone for 900 numbers, collect calls, and long-distance calls.

Keep checkbooks and credit cards locked up. Review credit card and bank statements on a monthly basis, and periodically request credit reports from credit reporting agencies.  Lock up valuable possessions or keep an inventory of items accessible to people working in the house.

You can help to prevent elder abuse to your loved one by: 

• Make sure the home health care worker thoroughly understands his or her responsibilities, the elder care recipient's medical problems and limitations, and how to cope with stressful situations.


• Do not overburden the home health care worker.


• Encourage openness over potential problems.

The following are possible signs of elder abuse or neglect: 

• Personality changes


• Crying, whimpering, or refusing to talk


• Sloppy appearance


• Poor personal hygiene


• Disorganized or dirty living conditions


• Signs of inappropriate sedation, such as confusion, or excessive sleeping


• Mysterious bruises, pressure sores, fractures, or burns


• Weight loss

If you suspect abuse, act immediately.  Do not wait until the situation turns tragic.  Investigate the situation by talking to the elder care recipient in a safe situation, or install monitoring equipment. Examples of abusive behavior include yelling, threatening, or over controlling behavior that could involve isolating the senior from others. If the situation is serious, you should replace the home health care worker as quickly as possible. If you fear the elder care recipient is in danger, he or she should be separated from the home health care worker as soon as possible.  Place the elder care recipient with a trusted relative or in a respite care facility. Make sure your loved one is safe before confronting the home health care worker, especially if there is concern about retaliation.

Report the situation to Adult Protective Services after ensuring the safety of the elder care recipient.  The police should be contacted in the case of serious neglect, such as sexual abuse, physical injury, or misuse of funds.

Supervising a Home Health Care Worker

The most important thing to remember after hiring a home health care worker is to keep the lines of communication open.  You should explain the job responsibilities clearly, and your responsibilities to the home health care worker. Do not forget that the home health care worker is there for the elder care recipient and not the rest of the family.  For live-in arrangements, the maximum amount of privacy should be set up for the home health care worker's living quarters. Meetings should be set up on a regular basis to assure that problems are nipped in the bud.  If conflicts cannot be resolved after repeated attempts, than it is best to terminate the employee.  In such a case, you may have to either place the elder care recipient in a nursing home temporarily or hire a home health care worker through an agency.  Reserve funds should be kept on hand in the case of such an emergency.  

General Eligibility Requirements for Home Care Benefits

Hiring a home health care worker directly is usually less expensive than hiring through a home health care agency; but if the elder care recipient is eligible and you wish to use assistance from Medicare, you must hire someone through a certified home health care agency.  For the senior patient to be eligible, three or more services must be ordered by a physician. Other factors or eligibility are the required need for skilled nursing assistance, or one of the following therapies: physical, speech or occupational. The elder care recipient's medical needs will determine asset and income requirements.

Hiring Home Health Care Workers through Home Health Care Agencies versus Independently

Different health professionals can assess the elder care recipient's needs.  A nurse or social worker can help with design and coordination of a home care plan.  Your care manager, doctor, or discharge planner can help with services being covered by Medicare.  They generally help make the arrangements with a home care agency.

You should ask the home health care agency how they supervise their employees, and what kind of training their employees receive. Find out the procedures for when an employee does not show up.  Also ask about the fee schedule and what it covers, there may be a sliding fee schedule. Furthermore, find out if they have a policy for minimum or maximum hours. Ask the agency if there are any limitations on the types of tasks performed.

Especially if you have to pay for the care services yourself, find out if there are any hidden costs such as transportation.  If all the costs for hiring a care worker through an agency become too much, you may want to consider hiring directly. 

Hiring independent home health care workers is not only more economical than using an agency, but it also allows more direct control over the elder care.