What are ADLs and IADLs?

You think you or your loved one might need some help around the house, but youre not sure what. Youve done a bit of research, but the language can be confusing. Whats the difference between home care and home health care? What services does a companion provide? And most importantly, which services do you need? Each type of service, from companion care to skilled nursing care, caters to different needs and offers varying levels of support. Knowing the differences can help you make an informed decision thats best for your family, says Siarra Thorning of Right at Home Grand Junction. Heres a breakdown of the primary in-home caregiver services available. Companion Care (or Sitter Services) Companion care, sometimes known as sitter services, mainly provides companionship for seniors or individuals who do not require intensive medical care but may need supervision and light assistance. This service is ideal for those who wish to remain in their home and maintain a level of independence. Companion care helps ensure the individual is safe in their home and gets regular social interaction. Caregivers in this role engage in activities such as:         Conversation and companionship, including hobbies, games, and walks         Meal preparation and dining company         Light housekeeping         Errand services, such as grocery shopping         Transportation to appointments or social events         Medication reminders Companion care is suitable for individuals who are mostly independent but may be at risk if left alone for long periods, such as those with early-stage dementia or limited mobility, says Thorning.  Personal Care (or Home Care) Personal care professionals provide a more hands-on level of support, helping with the personal care of an individual. This service is often more generally called home care, explains Thorning.  These caregivers have more training than companion caregivers and can assist with the physical aspects of daily living. Their tasks typically include:         Bathing and personal hygiene         Dressing assistance         Mobility assistance         Incontinence care         More detailed medication management         Monitoring of vital signs under some circumstances Personal care is ideal for individuals who need regular assistance with personal care tasks but do not require medical intervention. Its a good fit for those with moderate disabilities or more advanced stages of age-related conditions. Home care visits are typically a minimum three-hour shift as often as needed up to 24/7 care and can continue as often as visits are needed. Nursing Care (Home Health Nurses) Nursing care at home is provided by registered nurses (RNs) or licensed practical nurses (LPNs). This type of care is necessary when an individual needs medical care at home, whether theyre recovering after a hospital stay or need help managing a chronic condition such as chronic lung or kidney disease. Home health nurses perform a range of medical tasks, including:         Wound care         Administering medications, including injections         Pain management         Medical equipment operation         Monitoring health status and adjusting care plans accordingly Nursing care is suited for individuals with significant medical needs that require professional health monitoring. Its commonly used for recovering from surgery, managing serious illnesses, or managing complex health conditions requiring regular medical attention. Home health visits are often intermittent and limited. As Thorning notes, They last until recovery goals are met or the health care provider certifies the visits can continue. How To Decide What Type of In-Home Care Is BestThorning says its common for care needs to cross over these categories. For example, someone who needs a nurses help managing their lung disease at home may also need the housework-type help provided by a home care aide. Here are some additional thoughts to help with the decision:         Evaluate the individuals level of independence and medical needs. A person with lung disease may not need help around the house.         Consider the care recipients preferences and financial situation. Insurance (including Medicare/Medicaid) typically does not pay for in-home care or may pay only under limited circumstances.         Consult with healthcare professionals for tailored advice and guidance. What kind of care does the primary care physician recommend? Patients who are being discharged from a hospital or nursing home may also receive recommendations from the discharge staff. Remember, advises Thorning the goal for receiving care or assistance at home is to maintain the highest quality of life possible. If you are helping a loved one or friend decide on care, respect their wishes and needs as they age or recover in the comfort of their own home. Questions To Ask When Considering In-Home Care Providers As you research in-home care options, ask each provider these questions to ensure the company is reputable and will provide exceptional, quality care:         Are Social Security, federal and state taxes, and unemployment insurance paid? Are the caregivers bonded/insured? Are workers compensation and professional liability insurance paid? A trustworthy company will pay the taxes and insurance for its caregivers, so you are protected from legal and financial responsibility.         Is the required state licensing up to date? Have all caregivers undergone background checks, including references and criminal records?         Are supervisory home visits conducted to verify that quality care is being provided?  Asking these questions will help sort out which providers have a good reputation and are highly regarded in the community and which do not have these qualities. Above all else, ensure that dependable, quality care will be provided by people you can trust.About Right at Home of Grand Junction   2777 Crossroads Blvd Ste 3 Grand Junction, CO 81506 Our office of Right at Home is a locally owned and operated franchise office of Right at Home, LLC, serving the communities of Mesa, Garfield, Eagle, and Pitkin Counties.  For more information, contact Right at Home by Calling 970-697-1331 | Email: Care@gjhomecare.com | Web Address: www.gjhomecare.com  

What We Dont Know We Dont Know in Health Care:The Importance of Keeping Our Loved One Comfortable Towards End of Life, and Why Its Often Not Done. Introduction:Maintaining comfort and peace in individuals that are nearing the end of life is so important, yet too often I do not see this being done. I was recently privy to a situation where, per family report, their aging loved one was in a facility and restless for days on end without any intervention. I mentioned to the family that they may want to ask for some medication to relieve their loved ones restlessness. One of the family members reported back that within hours of our conversation, their loved one received such a medication. The family stated after receiving this medication that he was the most peaceful he had been in over a week. I could feel the relief in their voices. Unfortunately, I have seen this so often that it was the impetus for my next blog subject. Factors:I see multiple factors accounting for why individuals approaching the end of life are not made as comfortable as they should and could be. At facilities, one common reason is due to the transitional period that occurs once an individual or family decides they want to move from aggressive treatment to hospice or palliative care. Generally, once these wishes are expressed, a hospice consult is placed. It often takes time (sometimes up to a day) for the hospice team to evaluate the individual. Unfortunately, facility staff often wait until the evaluation is complete prior to initiating comfort care protocols. This does not need to be the case. Staff can initiate comfort protocols by reaching out to a practitioner to request orders. Many staff either do not appear to realize that they can initiate this order set or are too busy to do so.  The bottom line is that if the individual and/or family has consented to comfort measures and no aggressive treatment, protocols can and should be implemented right then and there. It often takes probing from an advocate or a family member to do so. Another reason individuals do not receive comfort medication at end of life is due to the practitioner being unaware of their discomfort. With the overburdened medical system, practitioners often do not get to spend ample time with their patients. They often only have a few minutes to round and hence may be unaware of their patients pain, agitation, or restlessness. This is where it can be helpful to have an advocate or loved one relay to a practitioner the observation that the senior individual is in distress. Much like a mother is attuned to her infant, often family members or others intimately familiar with an individuals behavior are the ones that pick up on subtle cues of discomfort or distress. In the situation I described above, the family of the restless individual stated the health care team appeared unaware of the individual's discomfort. One of the family members was with the loved one for hours on end, and she stated that his restlessness was very intermittent.  With that being the case, the restlessness could easily be overlooked by staff. In addition, facility staff are extremely busy and may not take the additional time to communicate restlessness to practitioners unless asked to do so by an advocate or loved one. One final reason I see individuals at end of life not receive adequate comfort medication is due to reluctance of staff to provide adequate comfort medication. Many nurses are hesitant to administer reasonable amounts of such medicine for fear of hastening death or euthanizing someone. I generally do not see this with hospice or palliative care staff as they have ample education on the importance of maintaining comfort in end of life and how to do so. I instead see this with general facility staff who may not have the training or experience in palliative/hospice care. Years ago I was sitting with family in a hospital room of their loved one as he was passing. The individual was clearly restless: pulling at his tubing and attempting to get out of bed. I was concerned not only for the discomfort of the individual but also the toll his discomfort was taking on family. No one should have to witness a loved one near the end of life suffer if its possible for the suffering to be alleviated.   I asked the nurse if she could administer more medication to relieve the individuals discomfort and she replied that she didnt have an order to do so. I kindly asked that nurse to communicate to the attending MD that the medication provided was insufficient for this individual and request a dose increase or another medication. She did so and the individual ended up receiving the appropriate amount of medication needed to pass away peacefully. Conclusion: The bottom line is that we all deserve to be comfortable at the end of life. It often takes an advocate or loved one willing to speak up to ensure that this gets done. Promoting comfort not only provides dignity and peace to the dying individual but also priceless peace of mind to the loved ones involved. I am a passionate, vocal advocate regarding the importance of ensuring this for families and their loved ones. Any questions please do not hesitate to contact me.

Im sorry to hear youre dealing with this difficult situation. When parents refuse care, especially if their health or well-being is at risk, it can be incredibly frustrating and stressful. There are a few things you can consider doing, depending on their specific situation, their reasoning for refusing care, and the legal options available to you:1. Understand Their ConcernsWhy are they refusing care? Sometimes, older adults resist help because they feel a loss of independence, fear of being a burden, or have concerns about the cost or quality of care.Have a conversation: Approach the subject with empathy. Ask them what specific concerns or fears they have about getting care and try to address them in a way that respects their autonomy.2. Discuss the Importance of Their HealthExplain how the care theyre refusing can improve their quality of life, maintain their independence longer, or prevent worsening conditions.Use specific examples of how delaying care can lead to complications (e.g., if they have a medical condition like diabetes, heart disease, or mobility issues).3. Offer AlternativesIf theyre against full-time care or a nursing home, offer other solutions, such as hiring a visiting nurse, a home aide, or setting up a family care schedule. This can make the care less intrusive.You might also want to suggest telehealth appointments if theyre hesitant to go to in-person appointments.4. Get Help from a ProfessionalTherapists or counselors: A neutral third party, such as a therapist or social worker, might be able to help mediate the conversation and address any fears or emotional resistance.Doctors advice: Sometimes, having their doctor explain why care is important can be more persuasive than anything you say. This might involve setting up a meeting where the doctor can directly discuss the necessity of care.5. Check for Cognitive ImpairmentIf their refusal of care seems irrational or if they are not understanding the risks, it could be a sign of cognitive decline (e.g., dementia, Alzheimers). If you suspect this, a doctor or specialist should assess their cognitive function.Legal options: If their cognitive state is compromised and they cannot make decisions in their own best interest, you might need to consider legal options like guardianship or power of attorney. However, this can be a delicate process and may require legal advice.6. Know Your Legal RightsPower of Attorney (POA): If your parents have given you power of attorney for healthcare or finances, you may be able to make decisions on their behalf, including arranging care.Guardianship: In extreme cases, if your parents are unable to care for themselves and are refusing help, you may need to pursue legal guardianship. This is a process that involves the court and can give you the authority to make decisions for them.7. Consider the Long-Term ImpactIf they continue refusing care and their health worsens, it might become a situation of crisis care, meaning emergency intervention could be needed. However, you should try to avoid this if possible since it can cause additional stress and trauma for both of you.8. Take Care of YourselfCaregiver burnout is a real concern. If youre feeling overwhelmed, its important to seek support from other family members, friends, or professional caregivers. Caregiving can be emotionally and physically exhausting, so make sure youre taking care of your own well-being too.If this is something youre dealing with, youre not alone. Many people face similar struggles with aging parents or loved ones. Taking small steps, seeking professional advice, and prioritizing communication can often make a big difference. Let me know if youd like specific advice or resources on any of the points.For more information, please contact:  www.seniorhousingsolutions.net