Home Health and Cognitive Impairment, with Shawn Weiss

*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

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And welcome back everyone to the answer for elders podcast network and we are here with Dr Shaun Weiss from the senior health and wellness network. Shawn, we’ve been talking a lot about fall and and fall prevention and getting ready for winter, but you know, one of the things that I really want to zero in on. What you do is you specialize in what’s called home health and a lot of us we talked about home care, we talked about the difference between home care and what many of us called skilled care. This is a a lot of the lingo in our in our industry. So first of all, obviously you are part of the skilled care side, which is the home health side, which means you have nurses and and physical therapists and occupational therapists and you actually work with seniors to rehabilitate sometimes to get to gain strength. Tell us a little bit about home help. Well, home health and now it’s at it’s really in the forefront because since the pandemic, people want care in their home. They don’t want to take the risk or they’re at high risk for catching and infection. So home care is had to, you know, evolve and be adaptable, adapted to all of these things that are happening right now. Home Health in general, you know, our job is to come into the home. We do skilled care services, so select home care for instances a license skill care agency, so we are Medicare certified and we are providing skilled services, working with your physician so nursing, Ptot, speech, social workers, home health aids. That is all signed off on by your doctor. So, and that’s the difference, you see a lot of home health care versus home care. So there’s a medical skilled care, which is what we do, and collaboration with your physician, and then there’s non medical home care, which provide also wonderful services and needed services, especially right now. And non medical care are dealing with, you know, your sitters, that maybe grandma needs somebody to sit with them for safety, Home Health AIDS, morning and evening care, house keeping, meal prep, transportation to appointments and the one thing about yeah, bathing, dressing, grooming task usually those are really kind of all a cart. Which is nice about these agencies is what do you need? Okay, let’s pick from the list of what you need and how many hours a day you need it, how many days of wait and week you need it. So those are non medical services provided by home care agencies and those are not always paid for by insurance. There’s usually some type of out of pocket cost for those. Correct versus skilled home care, which is what we do, which you know your agencies are Medicare certified or some type of federally certified in or State Certified Agency, which means they meet all federal and state say standards. You know, we’re surveyed on those things. So that’s something to definitely look for. But if your loved one has fallen, if they’ve been in the hospital, you’ve probably heard somebody recommend home care into the home. So if you’re not familiar with it, we require doctors order for that. So but then there’s so many providers out there. You know, how do you choose right? So the topic you know of today with this is how do you choose a provider if you need whether it’s skill care, good question, or non skill care. So and what’s the process? Is the second part to yeah, exactly. So you might know that you need services we’re pay. Is it going to be skill care or is going to be non skill care? So you first you need to know what it is that you need right that way you are going in the right direction. On which type of agency to pick, you want to make sure that you’re dealing with agencies that are certified and you can ask them if their Medicare Medicaid or there’s chaps certifications and things like that, where that agency is meeting rigorous standards that to be compliant with safety and protocol. So that’s definitely for sure. Something else I always ask is is what are your clinician qualifications in terms of our N’s or Lpns? Physical Therapist, physical therapy assistance, Ot occupational therapy assistants are the what’s their level of education? Do you have drrate level clinicians? Are Your Home Health Aid State Tested Home Health AIDS? Those are the questions that you want to ask. You want to make sure and I can tell you if you have a certified agency they’re doing background checks. That’s it’s a requirement, but always safe to ask about background check x. How often they’re done? Are they repeated on an annual basis? Those types of things are really important. There’s always a way to find out that agency’s clinical satisfaction rating. So there’s a patience right now with Medicare aage as a patient satisfaction raging rating and a clinical satisfaction reading when I could get on my soap backups about all kinds of things with those, because it’s pretty suffective. But the patient satisfaction rating is super important. That’s where you know if you’re with an agency that’s Medicare certified. You have to serve you. We want you to survey our agency on patient satisfaction. They’re going to ask how your care was or going to and you should be getting surveys and be an asked about the quality of your care. And if you have a complaint, what’s the process to make a complaint? So these are all the things that you need to think about when you’re ready or searching for a skilled home health care provider. Do they have nursing seven? Is Somebody on call every day? That’s another important question. Yeah, but a lot of times, honestly, most people are getting ready to have home services or maybe it’s for mom or data grammar GRANDPA and you just don’t order to look. Usually you’ve always know somebody like it. Maybe a family members had an agency come in in the past or a neighbor highly recommends an agency. That’s always a good place to start, is going off of local recommendations about making your for your phone call. So that certainly plays a rule too. Yeah, so obviously it’s just put up a scenario. Let’s say you see mom or dad grabbing furniture. Is that a warning sign that potentially you could actually have them be working with you and build some strength une. Right. Well, if you if you’re noticing that they are just becoming more unsteady, HMM it. Maybe they haven’t fallen yet, but you’re noticing something. Doesn’t a right, is it? Or is it their vision? Are they having pain? Are there? There? They start a new medications. There’s something that’s contributing. So the first thing that we for something like that is that you want to make a physicians appointment. You want to go to the doctor Maine and maybe you’re aw some labs. Say what’s happening. There’s been any decline, especially if there’s any type of functional decline like that, your physicians going to look at all the diagnosis that could be causing that decline. Right. So, do you have COPD and you’re more more shorter breath? So you’re more shorter about, your endurance is down, you start becoming weak. So that relates all the way back to this, the COPD. Right. So what is cossibly contributing? Or there might be multiple right. You Know Se’s are contributing to what you’re seeing in front of you. Mom grabbing the furniture and right, being steady. So the first thing is to get an appointment with the doctor so the doctor could say, you know what, one are your homebound, and that’s going to be the one thing we haven’t talked about yet. Is Why it’s the important to you do have to be homebound to get skilled home care, but doesn’t mean your bed bound. No, but hey, you know what, you’re going to highly benefit from some strengthening from somebody to come in and do education and teach you how to do these things. Let’s get you stronger, let’s build your endurance in a safe way. Yes, have a nurse look at the medications, make sure that everything is only up and up, and let’s get services in the home. Sure. So that’s your first step, because it’s Dr Order. We need a physician’s order. So going over you know, eligibility for home care is one thing, but you do need to be homebound and for skilled home care savers is to be paid for by your Medicare, and that can mean a variety of things. Again, you don’t have to be homebound. It just means that you need assistance and you have some type of issue to where it is risky and you need somebody to be supervising you to leave the home right if you’re getting in the car and driving every single day. Skill do not cares not going to get paid for right. Yeah, because they’re looking at can you go down to outpatient clinic because that’s cheaper for Medicare for you to do that, because you’re going to pay a copay. Right. That’s just the that’s the lowdown of it, about money. So they want to know. Well, are your homebound or you still driving? So there’s one of the things we have to differentiate when when we’re looking for eligibility to sure sure that totally make important thing and, like I said, you know get back. You know I get off, I get off task when I talk about this stuff. So the difference between skilled care and non skill care. Again, when you’re looking at trying to decide, a lot of times, you know we will one more recommend the other. So you certainly can have both coexisting and absolutely that so much since the pandemic. We’re, you know, once we’re able to get enter people starting to feel comfortable having essential staff like nursing and PT and ot coming back in, you know, because we don’t want people to go to the hospital. Our number one job is to maximize the highest level of independent function and our clients in the safest manner. Yeah, in the intern preventing falls, preventing unnecessary doctor’s visits, preventing unnecessary trips to the hospital, because nobody wants to be going to the hospital right now. Let’s basically, wants to take that risk for exposure. So they want to have somebody come in and to take care of that without having to make numerous trips outside. And I’m having that coexist is important. You know, we will have somebody that we like it they are not safe to leave the home, they are having a lot of issues, they are high risk for falls, but we’re only there a few hours. You add them all up. During the rain, we might recommend non medical care to come in and and help them with housekeeping or meal prep or transportation, so that we are co existing with each other and working as a team. Yeah, so really what I’m hearing is the first step starts with the doctor, right, you know, the doctor would would and then usually it’s interesting because there’s a lot of times like an for example, a social worker discharge planner will just sign you up on home health and I want to make sure that everyone of our listeners know that you have a choice who you go with. You don’t have to absolutely the a home health agency that you’re discharge planner books you with. Sometimes we think that’s just the way the process is without really out it, and I think that’s something that, you know, part of us being really good advocates for our loved ones is making sure that you’re doing the right research on is this going to match with the values and the specialty of what they do with my loved one, because a lot of times a discharge planner, they’re just trying to do their job and they they do a great job and I’m not ready. They do just but they just are. They have a million things on their plate and they do whatever’s though. You know, yeah, and if you’re in the hospital and you’re going to be discharged, you know ain’t it. Let’s face at the hospital systems usually own their own home care and they own the nursing home and they own the outpatient clinic. But it is super important and, like I said, I’ve been doing this for eighteen years. Having an agency is to remind patients that they do have a choice, that you can have that prescription and you can take it to any home care agency if you know it, but maybe you have a great experience with the one. For sure contestic, but you do have a choice. You don’t need to do that. So it’s important to ask the right questions and to advocate your right for your love. Absolutely, absolutely. And coming up next, Shan is going to talk about what does it really mean to be homebound? How can you be eligible for skilled home care, specifically and home health care, and what does it mean and how unique get started? Shawn will be right back after this. We would like to thank you for listening to this podcast by Doctor Shawn Weiss, CEO of Senior Health and wellness group, focusing on wellness and prevention strategies for seniors. As a fall prevention specialist, Doctor Weiss provides family support and education to keep your loved one safe. You can learn more by visiting her website at www dot senior health and wellness dot org.