© 2023 Allay Home & Hospice
All Rights Reserved
All Rights Reserved
Text JoinTeam to 97211 to learn more about career opportunities today!
Text JoinTeam to 97211 to learn more about career opportunities today!
Regardless of sexual orientation, gender identity, or who you love, everyone deserves to feel safe receiving the care they need. For LGBTQ+ folks, hospice care can look different than it often does for cisgender, heterosexual people. As a healthcare care provider, we take the time to understand patients’ personal needs and guide them through their journey with patient-centered, inclusive practices.
A 2018 AARP study showed that 60% of LGBTQ+ people worry about a lack of sensitivity in their healthcare. Having multiple barriers to high-quality healthcare, such as poverty, racism, disability, and location, can also make it more challenging to find a provider who can meet their needs.
To practice equality in healthcare, everyone should receive care tailored to their needs and get information that will help them most according to those needs. Making hospice care more accessible to marginalized groups, like LGBTQ+ people, means we must understand their experiences beyond physical symptoms, too.
Inclusive care in a hospice setting involves treating each patient individually while validating the varied parts of their identity and taking the time to learn about the unique experiences within the LGBTQ+ community. It can be as simple as using the person’s correct name and pronouns and treating them with the same respect you would for any straight, cisgender patient.
Many LGBTQ+ patients have “found family” involved in their care instead of, or in addition to, blood relatives to support them. Additionally, if the patient wants spiritual guidance, a hospice care provider should be able to help find an LGTBQ+ friendly chaplain and other supportive resources that respect the person’s identity and wishes. Plus, showing sensitivity about the patient’s previous healthcare experiences can help them feel more comfortable receiving care from their current provider.
Healthcare focused on equality creates a broader understanding of diverse experiences that allow providers to offer specific care and help patients with thorough knowledge. It gives patients and their families more support and well-rounded information that applies specifically to them.
Many LGBTQ+ patients have their symptoms and concerns dismissed or devalued in typical medical settings. As a result, many are reluctant to share their needs or experiences for fear of discrimination. When we as providers understand this reality, we can help the LGBTQ+ community feel safer receiving hospice care. It ensures that patients have to do less work to be understood and receive the necessary care, especially while healing or going through the hospice journey.
By validating and including patients’ identities and being mindful of them in their care, providers give loved ones the space to be with the patient while they receive care. While communication between patients, providers, and others involved in care is important, having a provider who understands that the LGBTQ+ community has unique needs and struggles reduces the burden on patients.
We focus on healing, support, and balance between offering physical care and emotional healing. We want our patients to feel comfortable asking difficult questions, sharing their experiences, and knowing they have someone who will listen to and advocate for their needs. We know how overwhelming hospice can feel for many LGBTQ+ patients and their loved ones, and to us, inclusivity means providing care that reduces anxieties and makes end-of-life transitions as comfortable as possible.
Our care is all about love and healing, whether that be physical pain or emotional support. By presenting all options and giving patients control, we offer excellent palliative care that extends to emotional, mental, and spiritual needs.
Please contact us to learn more about how we provide equitable, compassionate hospice care.
References
May marks Older Americans Month, a time to celebrate the lives and contributions of people ages 65 and older. Older Americans are living longer, more productive lives than ever before, and they constitute a growing segment of the U.S. population. According to the 2020 Census, more than 55 million people aged 65 and older live in America today, and those numbers will grow in the coming years. By 2030, every member of the Baby Boomer generation will be over 65. By 2040, 22% of the U.S. population will be over the age of 65.
Aging and retirement bring new opportunities for community and family engagement, but they can also bring new health concerns. As our older Americans age, they should know the options they have in their healthcare journey.
The majority of older adults prefer to live at home, even if they have health conditions that require frequent care. Home health care services allow individuals with long-term or chronic conditions or people recovering from an illness or injury to be in a comfortable, stress-free environment while still getting the support they need. Home care can be a short-term or long-term service. Choosing home health may prevent unnecessary hospitalizations in the future and speed up recovery.
Home health care services can be adapted to the individual’s needs. Home health provides work with the individual’s doctor to make a care plan. Each plan will be tailored to the health and well-being of the person receiving care. Our services ensure that the home environment is conducive to supporting the healthcare needs of older adults. Our care providers focus on the following:
Many families find that end-of-life care for a loved one comes with complex medical and emotional needs. Hospice care is a health service to address the needs of individuals and families facing a life-limiting illness. Hospice services can be delivered in the home so individuals can live their last days with respect, peace, and dignity in familiar surroundings.
A hospice care team includes a hospice volunteer, registered nurse, social worker, home health aide, and chaplain. The care team and the family determine the care plan, and hospice staff will work with families to make any necessary changes.
Our services are focused on managing pain and increasing comfort for the individual. In addition, hospice care offers resources for emotional and spiritual health, as well as managing the person’s physical needs. The hospice care team will also be available for family members who need support during this challenging time.
If you or a loved one needs care at home, you have many choices of home health and hospice providers. Only you and your family can know which provider is the right option for your needs. Your hospital or physician can advise you on your options, but the choice is ultimately up to you.
To learn more about the services we provide, contact us at 262-787-2980 .
We’re excited to honor our skilled nursing care staff and facilities in the markets we serve. Founded in 1967 by the American Health Care Association (AHCA), this annual celebration includes a week dedicated to the huge role that skilled nursing care centers and their staff play in improving the lives of their patients. For 2023, National Skilled Nursing Care Week will be celebrated the week of May 14-20.
Though the premise of this celebratory week remains the same each year, each year has a new theme to celebrate. For 2023, the theme of “cultivating kindness” is celebrated, an honor to the many acts of kindness that Skilled Nursing Care staff perform every day. Although each of these small acts of kindness may not be recognized by all, this week-long celebration acknowledges every one of them.
Our skilled nursing care partners serve an immeasurable role as the main referral sources and partners in providing care to those who are sick or living with a terminal illness. If individuals are discharged from skilled nursing facilities to return to their homes, hospice and home health providers help during the transition. As such, we recognize the importance of this hand-off care that is made possible by skilled nursing care staff and facilities.
When an individual is discharged from a skilled nursing facility to go home, ongoing care is vital to their health and wellness. In many instances, home health services are recommended to allow patients to recover from an illness while returning to the comfort of their own homes. Under the oversight of home health professionals, individuals can begin returning to their daily routine and activities they love, while still feeling supported each step of the way.
For individuals diagnosed with a terminal illness, hospice care can help support a comfortable and pain-free environment at home. Our team offers supportive hospice care, supporting both individuals with terminal illnesses and their loved ones.
Join us in celebrating National Skilled Nursing Care Week, acknowledging the superior work of the amazing skilled nursing staff in our community’s facilities.
In the United States, one in five adults will experience a mental illness in any given year. This includes a large number of people who are living with a terminal illness—and their caregivers—who must cope with facing the end of life and making the necessary arrangements.
May is Mental Health Awareness Month. As one of the country’s leading hospice providers, our team is devoted to connecting you with the care you need if you are living with a mental illness.
Mental Health Awareness Month was established in 1949 by Mental Health America. The goal of this observance is to help Americans understand the importance of achieving good mental health and to empower people with mental health issues to seek treatment. Mental Health Awareness Month is an opportune time to learn about the causes, symptoms, and treatments of various mental health disorders.
This year’s theme for Mental Health Awareness Month is “Look Around, Look Within.” It calls for Americans to focus on how one’s surroundings can impact their mental health. Specific topics that align with this year’s theme include:
If you can identify specific factors that may be impacting your mental health, it’s time to make changes to your surroundings that can get you on the path to feeling better. For example, if you have a serious, debilitating health condition affecting your ability to carry out normal everyday tasks, it may be time to seek assistance from a home health care provider.
Caring for your mental health is just as important as caring for your physical health. Experiencing mental health symptoms like sadness, depression, anxiety, and stress every day for a long period can affect your career, relationships, social life, and general well-being. An untreated mental illness can also increase your risk for a wide range of physical health problems including diabetes, stroke, and heart disease.
Unfortunately, stigma continues to surround mental illness and prevents many people with mental health problems from seeking the help they need to become healthier and improve their quality of life.
Mental health treatment can help you identify the factors in your life that are causing your symptoms and empower you to make changes that can reduce their impact on your mental well-being. If you are living with a terminal illness, seeking mental health treatment is especially important given how terminal illness places you at higher risk for anxiety and depression.
Having a terminal illness—such as cancer—is one of the top risk factors associated with mental illness. If you have a terminal illness or are caring for someone with a terminal illness, you may need help coping with certain treatments and with facing the end of life.
We offer hospice services that are personalized for every patient based on their mental, physical, spiritual, and emotional health needs—including mental health treatment. Counseling, bereavement, and support group therapy are some of the many mental health services offered by our hospice care providers. Our interdisciplinary teams are comprised of compassionate physicians, nurses, social workers, chaplains, and others who are dedicated to helping you and your loved ones navigate a terminal illness while caring for your mental health.
If you are suffering from a mental health issue, don’t hesitate to speak up and come to us with your concerns. We will be more than happy to connect you with the help and treatment you need and guide you and your loved ones toward finding the right treatments that can improve your quality of life.
Contact us today to speak with one of our representatives and learn more about our hospice and mental health services.
In acute healthcare settings, such as an inpatient stay at the hospital, the quality care delivered to patients is facilitated by readily available resources such as multidisciplinary healthcare teams all operating out of one facility. A multidisciplinary team can include your doctor, spiritual counselor, social worker, and bereavement counselor to name a few. Following discharge from an acute healthcare setting, more senior patients are often sent to post-acute healthcare settings. These are settings that reside outside of the hospital and can include skilled nursing facilities (SNFs), long-term care hospitals (LTCHs), inpatient rehabilitation centers and home care agencies. At these facilities, individuals traditionally experience longer stays and therefore continue to benefit from the multidisciplinary services mentioned above. In all of these settings, the availability of such resources, especially counseling, is critical to the long-term health and wellness of residents. April is recognized as National Counseling Month, and we can’t overstate the importance of counseling for individuals in any stage of care. Fortunately, a number of counseling services are readily available to individuals requiring long term care. Three of these services in particular include social work, bereavement, and chaplain services.
Social workers work within a healthcare team as vital advocates for patients and primarily serve individuals that are identified as “high-risk”. In that high-risk category fall senior citizens. Older individuals often reach a point where they can no longer care for themselves independently and rely on family or friends to provide care. This is sometimes the turning point at which you or a loved one may turn to long term care as the best option moving forward. In long term care, social workers can play a pivotal role in identifying where an individual may require the most help, whether that be emotional, financial, family, or other support. Social workers work closely with the rest of the healthcare team and take the lead as a case manager for individuals with psychosocial or financial issues. They also operate as a collaborator for high-risk clinical issues. Not all individuals in long term care will require extended counseling from a social worker, as it will depend on how high risk an individual is. Nonetheless, knowing the services available to you or your loved one can make a difference in receiving the support you need and resting assured that you are being well taken care of by your healthcare team.
Bereavement counseling is unique in that it is a service dedicated to your family after your loved one has passed away. The primary purpose of bereavement counseling is to help families navigate their grief following a loss. This particular service is incredibly valuable as it is virtually impossible to be fully prepared for what life after loss looks like, regardless of how long a loved one has been ill or how much a family has tried to prepare themselves. Bereavement counselors can be a helpful resource when dealing with the emotions that accompany the loss of a loved one, the disruption of daily routines, the stress of managing the logistics, and the possibly changed outlook on life and mortality. When your loved one passes, care should not stop there; and with the help of bereavement counselors, it doesn’t. Having a supportive team who is familiar with navigating loss can be tremendously impactful and can often eliminate undue stress.
Spirituality can be an especially helpful source of groundedness during challenging times, transitional periods, or throughout the grieving process. Through that lens, chaplains can be vitally important to both your loved one as they move into longer term care and you, as the supporter and caregiver.
Many emotions can accompany the transition from living at home or occasional acute care stays into long term care facilities. Some individuals experience anxiety, sadness, loss of identity, fear, and anger to name a few. All of these emotions can present their own challenges and can negatively impact one’s experience if left unaddressed. Chaplains offer more than just spiritual guidance and can often help individuals navigate some of these confusing, frightening, or unfamiliar emotions. Among the many things chaplains can do for patients, some of the most beneficial services include cultivating new hobbies, facilitating new relationships, providing referrals to appropriate experts, and talking through tough emotions. Chaplains can help individuals see beyond the negative and find acceptance and hope even in challenging times.
As the family of a loved one in long term care, the burden of this transition weighs just as heavy on you. Fortunately, many of the long-term care services are available to help you navigate these challenging times as well. Chaplains can often serve as a guide for the new challenges that arise with putting a loved one into long term care. Similarly, the emotions you face may feel unfamiliar. Be sure to give attention and time to your own emotions, just as you do for your loved one, and consider utilizing chaplain services if you are seeking support during this time. Chaplains not only help to facilitate the sustainment or discovery of spirituality but also contribute to the acknowledgement and interpretation of emotions for individuals and families experiencing change, grief, or loss.
If you or a loved one are preparing to transition to a post-acute healthcare setting of any kind, be sure to discuss with your team of providers what counseling services are available to you and your family. The amount of support and care these services can provide outside of the hospital is extensive and can greatly impact the quality of a more long-term healthcare stay.
Sources:
Image 1:
https://www.counseling.org/knowledge-center/mental-health-resources/counselingawarenessmonth
Image 2: https://veteranlife.com/veteran-benefits/va-bereavement-counseling/
Image 3: https://www.yourtango.com/self/what-happens-after-spiritual-awakening
American Hospital Association: https://www.aha.org/advocacy/long-term-care-and-rehabilitation
MedPac: https://www.medpac.gov/research_area/post-acute-care/#
Net Health: https://www.nethealth.com/the-importance-of-in-home-bereavement-support-services-for-hospice-care/
Relias Media: https://www.reliasmedia.com/articles/148131-the-role-of-the-social-work-case-manager-across-the-continuum-of-care
Research Gate: https://www.researchgate.net/publication/337140540_THE_IMPACT_OF_SOCIAL_WORKERS_ON_POST-ACUTE_CARE_DISCHARGE_OUTCOMES
World Health Day is observed every year to bring awareness to the importance of practicing and achieving optimal health and wellness. In honor of World Health Day, our goal is to help you learn and understand more about specific healthcare services that can improve your quality of life if you are living with a chronic illness.
World Health Day occurs every year on April 7. It was created by the World Health Organization and founded on this day in 1948. The purpose of World Health Day is to promote and celebrate the importance of physical, mental, and emotional well-being.
April 7, 2023, marks the 75th anniversary of the founding of the World Health Organization. This year’s theme is Health For All. This day is the perfect time to reflect on the many public health successes that have shaped today’s healthcare industry and have greatly improved the quality of life for billions of people worldwide.
Suffering or recovering from a serious illness can be extremely stressful. Debilitating symptoms like chronic pain can greatly interfere with your quality of life, as can spending lots of time in sterile, hospital-like environments that take you away from your family and home. Home health and hospice care can make you feel happier, more comfortable, and less stressed—regardless of whether you are recovering from a short-term condition or coping with a terminal illness.
Home health focuses on helping you recover from an illness, injury, or surgical procedure. It can help you become more independent and teach you how to successfully live with and manage a chronic condition such as kidney disease, heart disease, or lung disease. This type of care is given to you in the privacy and comfort of your home.
Hospice care focuses on making you feel as comfortable as possible when living with a terminal illness, such as cancer. This collaborative approach involves physicians, social workers, spiritual advisors, hospice aides, and other healthcare professionals who strive to make your last days as fulfilling as possible. This type of care can be delivered anywhere you call home.
Home health is ideal for anyone in recovery from an illness, injury, or surgery who needs help getting back to their daily activities, but whose condition doesn’t necessarily require hospitalization. For example, home health may benefit you if you recently had open-heart surgery and must stay home for several weeks to recover and take it easy. Your doctor can determine whether home health services are ideal for you based on your unique condition and situation.
Hospice care is ideal for those with a terminal illness who want to reduce their pain and feel as comfortable as possible until the end of life. You may be eligible for hospice care if you have a terminal illness and need continuous oxygen, have difficulty swallowing, suffer from constant pain, or frequently experience shortness of breath. Your doctor can talk to you in greater detail about hospice care and determine whether you’re an ideal candidate for this service.
Knowing about various types of healthcare solutions, such as home health and hospice services, can help you make more educated decisions for yourself or your loved one.
We understand how overwhelming it can be to navigate and choose the best type of health care when you or your loved one is managing or living with a serious illness. Let us help you choose the right program to provide you or your loved one with the best possible quality of life.
Contact us today.
Each year, Patient Safety Awareness Week (PSAW) is recognized to remind healthcare staff of the importance of promoting patient safety practices. Whether you’re a Nurse, Certified Nursing Assistant, or another type of healthcare professional, the steps you take daily can go a long way in keeping your patients safe.
From preventing choking hazards to simple fire prevention techniques, check out these five preventative measures you can implement to keep your patients safer.
Elderly patients or patients in hospice are at an increased risk of falls, which can be caused by age-related loss of muscle mass, balance problems, cluttered environments, and so much more. While you’re likely already familiar with general fall risk precautions, one easy tip that is often forgotten is to ensure that a patient’s living area is adequately lit. According to the Centers for Disease Control (CDC), falls are usually caused by a combination of risk factors. The fewer risk factors a person has, the less their risk for falls is. As a healthcare professional, consider these ways to help encourage fall prevention for your patients:
Another vital part of keeping your patients safe is understanding oxygen safety and fire prevention techniques. Remind your patients on oxygen that oxygen is extremely flammable. Therefore, provide patient education and remind patients of the dangers of smoking near an oxygen tank. Furthermore, all patients who smoke should be made aware of the designated smoking areas around your healthcare facility.
For home care patients, healthcare professionals can also help support fire prevention by helping their patients perform regular smoke detector tests or replace batteries.
Another easy way to keep your patient safe is to follow proper eating protocols to prevent choking. Bed-ridden patients may wish to eat lying down. However, this poses a serious choking hazard. Before feeding a patient or giving them a meal, ensure they sit upright. After eating, patients should remain upright for at least 30 minutes to prevent aspiration. Any patient that has difficulty swallowing should take small bites with sips of liquids in between.
Most healthcare professionals already know that frequent repositioning is an important step to prevent bed sores. However, adequate nutrition is another essential component to help reduce the risk of bed sores. Research studies suggest a clear correlation between nutritional deficiencies and an increased risk for pressure ulcers. Healthcare professionals and dietary department workers should pay close attention to their patients’ diets, helping to ensure they have a well-rounded diet with nutrient-dense foods. For patients with poor appetite, supplemental nutrition may be needed to help obtain proper nutrition and prevent bed sores.
When it comes time to transport a patient, healthcare professionals have many things to remember. Especially for patients who need help to ambulate several times throughout the day, it can be easy for healthcare professionals to forget the most important safety precautions for safe ambulation. As you prepare a patient for transport, ensure that they have the proper footwear to prevent falls. Standard socks are not proper footwear. Instead, patients should have non-slip shoes or socks on. Taking an extra moment to ensure your patient has adequate footwear is a simple and effective way to ensure they are safely transported.
Patient safety is our utmost priority. To support this year’s Patient Safety Week, try implementing these five simple ways to keep your patients safe. Whether you see patients in a home setting or an assisted living facility, these tips can help reduce fall risk, prevent bed sores, eliminate choking hazards, and reduce fire hazards.
Even when you know someone is dying, watching a loved one take their last breath is surreal.
If they are on life support, once they are removed from it, their breathing may change pretty quickly, and then it stops. Natural death can be different. For several minutes, you watch their breathing change. It becomes shallower, intermittent, until with great finality, they take their very last breath. Then, nothing but silence.
The emptiness of that moment feels like it would suck you into it if it could. You cry, with a depth of pain that feels like it is tearing right through you. You want to get away form the pain, but there is nowhere to run to. Part of their legacy is tied to you, sewn into the very fabric of your life. In losing others, one can feel like they have lost part of themselves.
Maybe that is why anxiety and feeling unsettled is so common after losing a loved one.
In the acute phase of grief, there is physical and neurological consequence. One’s heart can actually change. Takotsubo cardiomyopathy (AKA broken heart syndrome) causes the heart’s main blood-pumping chamber (the left ventricle) to change shape and get larger. This weakens the heart muscle, and it doesn’t pump blood as well as it should. The symptoms usually last a few weeks, and one’s heart can return to normal function.
The word ‘takotsubo’ comes from the name of a pot used by Japanese fishermen to trap octopuses. When the left ventricle of the heart changes shape, it develops a narrow neck and a round bottom, making it look somewhat like an octopus trap.
Then, there is the brain’s response to grief and loss. One can experience changes in memory, behavior, and sleep. Cognitive effects can also happen. One common one is known as brain fog. These neurological changes are a protective mechanism in order to help us survive.
Perhaps that protective mechanism helps younger folks survive, but the risk in elderly survivors can also increase. The depression, anxiety, and physical changes reduce one’s motivation to get up and move Non-adherence to one’s medical regimen can be compromised, increasing hospitalization risk.
I’m not sure the last breath is an event one can prepare for. The emotional toll can last months or years.
Which is why our hospice bereavement is so important. We provide bereavement support for over a year to those who must move forward but feel like they can’t. Children – both young and old – and other family receive care while the world moves on around them.
Social work is a sector within the world of healthcare that is aimed at meeting the basic needs of individuals, families, and communities. Social workers provide support and act as advocates for patients who are working through psychological, health, family, and financial struggles. They can often refer patients to the proper professionals and can provide them with resources to assist with meeting needs such as housing, food, and therapy. Social workers are especially important when it comes to assisting patients who would have no means of bettering their living situation without help.
Social workers can work in a variety of different settings, and one of the settings where they offer a huge contribution is within home health. Individuals receiving home healthcare are often considered part of a vulnerable population as they are receiving care to assist with activities of daily living. Most individuals receiving home healthcare are dealing with physical ailments, mental ailments, or a combination of both. They rely on and trust the individuals that make up their team of caregivers. In addition to the medical professionals that provide home healthcare, social workers serve as a crucial component of a well-rounded support team.
When a loved one, a family member, or a friend is receiving home healthcare, having someone to look out for their financial situation, living condition, and mental health can help ease your stress and improve their overall quality of life. This is where social workers bring huge value to the home health world. There are several primary goals that social workers often focus on to best care for their patients. A safe living space is at the top of the list. Social workers can help to ensure there are no hazards in the home and that everything your loved one needs is accessible. Additionally, they can offer numerous programs and referrals to make sure the proper professionals are available to your loved one to meet their unique needs. This can include referrals to nutrition counseling, adult social care, support groups, transportation services, and more. The overall wellness and stability of your loved one can be preserved by the help of a social worker.
Well rounded and collaborative care is the most important thing for your loved one when they are receiving home healthcare. The role of the social worker compliments the medical team by paying special attention to the individual’s mental health and quality of life. Incorporating a social worker into the home healthcare of your loved one will elevate their quality of life and ensure thye are safe and supported in all the ways they need!
Image 1 – https://www.tuw.edu/program-resources/day-life-social-worker/
Image 2 – https://converge.colorado.edu/social-sciences/social-work/
Accredited Nursing –
https://accreditednursing.com/in-home-caregivers/home-care-social-workers-working-together/
Referring Patients and Family Caregivers to Community-Based Services: A Provider’s Guide –
https://www.nextstepincare.org/uploads/File/Guides/Provider/Community_Based_Services.pdf
The Critical Role of Social Workers in Home Based Primary Care – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790723/
University at Buffalo –https://socialwork.buffalo.edu/admissions/is-social-work-right-career-for-me/what-is-social-work.html
“Frailty is everyone’s business, and recognizing it improves outcomes and helps people live well longer,” said William Mills, MD, BrightSpring Health Services’ senior vice president of medical services, during Frailty: Why It Is Important, How to Identify It, and Programs to Help, a 2023 Clinical Impact Symposium webinar.
Addressing frailty is essential on many fronts. As Mills said, “Evidence shows that age, frailty, chronic disease load, and ADL dependency are predictive of mortality, hospitalization, and total cost.” At the same time, severe frailty is associated a five-fold higher risk of death at one year.
Frailty not only needs to be on your radar; you need a methodical, team-based, person-centered system to address this. The following are 7 elements your efforts should include:
Mills noted that frailty generally is “a clinically recognizable state in which the ability of older people to cope with everyday or acute stressors is compromised by an increased vulnerability brought by age- associated declines in physiological reserve and function across multiple organ systems.” He added that the most commonly used definition is the “frailty phenotype,” which consists of five physical components: weight loss, weakness, exhaustion, slowness, and low physical activity level.
Individuals aren’t likely to report that they are getting frail or weak. Instead, they may say things like: “The stairs are getting so hard to climb;” “Since my wife died, I just open a can of soup for dinner;” “I’ve lived here 40 years, and no other place will seem like home;” “I’m having more trouble getting around;” and “I’ve had a couple of falls – not too bad, though.” Family and team members need to be alert for signs that a patient is experiencing increasing frailty or frailty-related issues.
Mills said, “A clinical frailty tool should be quick, inexpensive, reliable, and easy to use in clinical settings because the identification of frail older people at risk is an important initial step potentially leading to appropriate preventive or treatment interventions and ultimately to higher quality care for this vulnerable population.” He noted that FRAIL scale is a simple questionnaire consisting of five yes or no questions addressing fatigue, resistance (inability to climb stairs), ambulation (inability to walk a certain distance), Illnesses (more than five comorbidities) and weight loss.
This scale, he said, has been shown to be able to predict mortality and incident ADL and IADL disabilities among community-dwelling older people in recent meta-analysis studies.” Other potentially useful instruments include the Clinical Frailty Scale, Edmonton Frail Scale, INTER-FRAIL Prisma-7, Sherbrooke Postal Questionnaire, Short Physical Performance Battery, and Study of Osteoporotic Fractures Index.
Mills said, “An exciting project we have worked on involves a claims-based assessment to detect frailty. This is a unique opportunity to identify patients who may need specific interventions and provide them with those services.”
This should include resistance training, aerobic exercise training, balance training, and flexibility training. Mills and Renee Lach-Sharon, PT, MS, CPHQ, manager of therapy clinical and quality services at Rehab Without Walls NeuroSolutions, who also spoke at the webinar, talked about a new BrightSpring exercise program adapted from a program at the University of Otago in New Zealand. “The Otago program initially focused on falls prevention and found it useful in this regard. It has shown that even in higher risk populations, it was able to reduce falls by 35%, and it improved things like mobility and hand grip strength. We are looking at using it with very old adults who have multiple risk factors such as arthritis and deconditioning,” said Lach-Sharon.
This involves an individually tailored, home-based balance and strength falls prevention program delivered by a physical therapists and available via home health. Lach-Sharon stressed that intensity is key to the success of this program. This means sessions three days a week for each category of exercise, with a rest day between exercising in the same category. “We are looking to roll this out in the home health environment. Each visit would be about 45-60 minutes, then we would conduct follow-up calls to check in. This is key to the success of the program, as we are trying to make this a lifestyle change,” said Mills, adding, “One goal is to get these individuals into community-based exercise programs for socialization. This makes a tremendous difference in compliance.”
This should include the use of your frailty assessment tool as well as measurements of gait speed, 30-second chair rise, and balance (4-stage balance test: stand with feet side by side, place instep of one foot so it is touching the big toe of the other foot, place one foot in front of the other – heel touching toe, and stand on one foot). Mills noted that, according to research, “The inability to stand on one leg for 10 seconds in mid to later life is linked to a near doubling in the risk of death from any cause within the next 10 years.”
Ideally, a good frailty program should be led by a trained physical therapist. BrightSpring is rolling out a national program currently. After starting the program led by physical therapy, leveraging technology, including efforts such as exercise videos and remote therapeutic monitoring can be useful as well. Make effective use of non- skilled staff and caregivers. For instance, consider using a standardized assessment tool to enable caregivers to address social determinants of health. “It is important to provide structure, clinical assessments and support between visits to assess frailty, falls risk, etc.,” Mills said, adding, “Make sure you provide a system for patients to get access to medications and maximize compliance with medication regimens.”
By assessing and addressing frailty, providers can manage patient proactively, instead of reactively. “We think an exercise prescription will be an innovative and exciting way to positively impact frail elders,” Mills said.
Allay Home & Hospice is an established, full-service Southeast Wisconsin home health and hospice agency that provides a superior quality of services in a caring manner.
Allay Home & Hospice prices itself by partnering with the We Honor Veterans Program. We have a team of highly-trained individuals who work with our Veteran patients during their time of need.