Terry Wilson and Sheena Paylor, area VP for Assured HomeHealth, talk about specialized services in home health. They work on specialties such as continence, which includes pelvic floor muscle training and bladder retraining, which has twice daily visits and gets results in four to six weeks. Also we help with lifestyle interventions, such as when to stop drinking before bedtime and what to drink. Anything that home health does requires an order from their physician.
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The following is a podcast from a qualified senior care provider, hurt, on the answers for elders radio show. And Welcome back to answers for elders radio everyone. I am here with Wonderful Terry Wilson and Sheena Paylor from assured home health in western Washington, servicing Snohomish through Cowlitz counties, and I’m so glad you can’t. Guys are willing to stay for another program because we talked a lot in our first segment about prevention, but I think there’s other things that you touched on in the previous segment about, you know, like continents programs and things like that that we may not think that home health agency can help our loved one. That Medicare pays for, by the way, as long as it’s prescribed by your doctor. So Terry and Sheena, tell us a little bit about some of the specialties that you guys. Yeah, we’re gone. We’d love to. So, specifically to our continents program it’s for both men and women. Some facts about continents that it affects twenty five million adults in the US. Women wait six and a half years to address it. A lot of it’s because of just embarrassment, because of what it is. However, our program is noninvasive, but the results and the outcomes are well worth them reaching out to get help right away. So what kind of things do you do for continent? It’s so what we do is we do a public floor, muscle training, a bladder retraining and scheduled voiding. Oftentimes people began to start needing to void throughout the night many times, which, as we mentioned in the previous segment, results and falls. Absolutely we do lifestyle interventions. Maybe that has something to do with medications, their diet, when to stop drinking before before bedtime or nerve time. We also do and what do you drink? Yeah, I think that exactly thing. You know. I mean I know that if I have a cup of herbal tea, tea is what a diuretic. So what is it going to make you do? Is Go to the bathroom, exactly, and a lot of elderly’s drink coffee and tea, as I know my grandparents all all day long, from start to finish. Absolutely, and you’ve got and you guys, you know, with this kind of a program, what couldn’t what can families expect or what kind of senior expect you guys come in and kind of work with the doctor. What specifically do you do to set up the program? It’s a very private situation, so it would be with our therapists would come out and have an honest dialog with your mom. She may not want you there as to how how bad it is or what’s going on with her speary. True, it’s one of the most private. That and money is the two things people have a hard time talking about them. And then, once they get the facts in order, they set up a routine and actually work with them. The first part is on relaxation, because a lot of that is just the urgency in the nerves and the fear. Teaching people how to relax. And then, let’s you mentioned retraining the bladder. So it’s twice a day. The program needs to be done. It’s made ten to fifteen minutes a time, morning and an evening, and they start to see results as soon as four to six weeks. Wow, that’s awesome. That’s awesome. It’s particularly proven to be helpful. Say a patient goes in the hospital and has a catheter inserted while they’re in there for surgery or whatever. Once that Catherine’s out. That’s often a trigger to someone starts to have some incontinence issue because they lose that, they lose that muscle and all they have to be is what’s considered homebound for Medicare. That’s a very gray type of term, but what that would mean is they can still go to church, they can still get their hair done, they can still go to the grocery, but they’re exhausted for the rest of the day or just wipes them out. It’s called taxing to get out of the house. So if you see that with mom, you see that within continents, call our office and we’re happy to have you assessed and get you started. Now, if you’re going to assess, don’t you need a doctor’s order or not on something like that? Anything that home health does with our patients requires an order from their physician. Okay, it’s something simple. Typically, if it’s something you’re wanting for, say, you’re getting involved in mom or Dad’s care, you can call the physician and have an appointment made to discuss it and they can send an order to us directly. Something to know if you’re starting to see some changes with mom or dad and and you’re concerned, are they starting to be less social? Oftentimes that relate very truth’s very true, and I think too, is just the overall you know, what’s their life too, style, like I you know, if they’re sticking close to home, chances are that might be part of it. And you know it’s so interesting, Terry, that you said that. One of the things you said is they’ll tell your therapist things they won’t tell their daughter. That is so, absolutely, so common in so many situations with our with our parents. They are still their parents, are parents, right, you are still the daughter, you’re still the son. So obviously they’re going to be strong for their kids, and strength in in a mindset of a parent doesn’t mean that they have continents issues, and so they’re not going to talk about it. Absolutely true. Good place to start if you’re questioning is check the waste basket in the bathroom and see if you find pads or depends. They might not have mentioned it, but they will be changing them throughout the day at least once or twice, or they’re wearing you know, those kind of underwear, which is often times. Will will be an indicator, which is true. So tell me a little bit about do you do other types of specialty type services? Definitely one of our fall prevention programs it’s called active life balance. The focus on that program is is towards dizziness. We work with neuropathy, so maybe someone has diabetes that the percentage of people falling just from having neuropathy is so high, over fifty percent. If you cannot fail your feet, it’s very, very considering. It’s and you know or COPD can happen to that was exactly oxygen exactly. We work with the vestibular system, which is the inner ear, which causes dizzyness and oftentimes people confuse it with Vertigo, but it really is something that we can help. We have therapist, physical therapists that are certified in a program called bbpv, which helps put those inner crystals back in place in their ear. And the stories that we’ve heard as far as patients that have had that done and the feeling they have just minutes after and they’re able to be mobile again and wow, and I sure that can again affect patients like that have Parkinson’s. I would a APP and MS space or ms that could be a certain or anything that has to do with balance situations, anything that you can do on that end to help with that. I’m sure is something that you would be considerable and it can be done multiple times throughout the year. You know, it’s not just a one and done situation. So when you come and do an assessment, we were talking a lot about that. You guys serve pretty much throughout, you know, greater Puget Sound. On what happens in an assessment. I’m just curious how how it looks, as typically it’s a lengthier visit by our clinician, typically between one to two hours. They sit down with the patient and they go over their health history, what their needs are and, most importantly, what their goals are. Where do they want to be at the end of my session? Do they want to be getting their mail on their own where that they used to do before this hospital episode maybe they had, maybe they had pneumonia, and their week and they want to be able to go to church again, and that’s where we’re going to tailor our plan of care is to what their goals are. And then you said in this earlier segment you talked about surveying the home as well. That happens also, I’m assuming, in this assessment always. Safety is always our number one focus with patients because we want them to be at home just as much as they do, and so we need to make sure that that environment is safe for them. And so if that means removing rugs or at least recommending, so we do a lot of recommending as far as what will be most safe for them. Maybe their shower needs some grab bars, maybe they need to set up there there things in their home a little bit differently just to avoid a fall or a reach that may result in a fall. Medication management is also key during the initial assessment and getting eyes on the nurses and physical therapist get eyes on what’s in those bottles. Are they accurate? Have they’ve been mixed up? What type of supplements they might not be, they might be taking or not that could affect it. Yes, and that is gone through, I think, almost every visit to make sure that those medications are being managed properly well, and you know, when you’re saying that kind of thing, it’s it makes me think about to son or daughter may not be there when you guys do the assessment. So when son or daughter are there, you know at the home, they’re going to say mom, what happened when you went home health came okay. So, if I’m son or daughter, obviously there’s hippolats things like that. But what? What? How can family support your efforts? If there’s a family that wants to be involved, we try to coordinate our visits with that. So maybe that’s great. We could do a day that they aren’t working or after work. We try to accommodate as much as possible. Whatever is going to result and better outcomes. Is is our focus and our goal, especially, as Terry mentioned, with the medications. Oftentimes patients are in hospitals and they’re on all of these new medications. They just want to go home, they don’t feel well. They saw a specialist, they have this medication from this doctor that medication from that doctor. So we’re really focusing on the education piece and teaching why, why they’re taking those medications, when to take those medications, how what they’re for, so they can be a better advocate for themselves and their health. Yes, and I think that’s so critical and and you know, when we’re talking about that is how can I be the best support for my parent? And you know, we talked about how to be a good watch dog but also I think it’s true to just sit down with mom and say, you know, how are you feeling? You know, what do you feel like in the morning when you wake up? Mom Is, does it take you a while to get going in the morning? Because sometimes that happens. I think you know, once you read, you know they get out of the bed, maybe they’re just not very responsive for a little while, or maybe they’re going to bed at like six o’clock at night or you know some of this crazy stuff because they just don’t have the energy throughout the day. I’m those are I mean, what are these indicators that would probably denote to talk to a doctor at that point. Definitely, if there’s any type of change in their normal activity, then it’s something worth talking about. A big portion of what home health does is a focus, especially by our occupational therapist, as they’re adls their active daily living. Absolutely, are they not doing what they used to do? Is it reducing are they not social? Are they not cooking? Maybe they baked a lot before and and they’re just not so those are things we want to focus on. So how do we reach you? Guys? It’s real easy. I’ll just give you our Seattle office as well as our website. Our parent company is the La to see group for a short home health here in Washington. So our website is LHC Groupcom. Our Seattle Office is to zero six three, six four, one thousand four hundred and eighty four, or my cell is always on and I’m happy to answer or find an answer for anyone, and that is two thousand and six three, zero, zero six thirty two. Terry and Sheena, it has been such an honor having you guys on the show. Thank you for sharing all of this information with our listeners to so. We really want to help people be able to stay in their home and stay healthy and we love it. Thank you both. Thank you. Answers for elders radio show with Suzanne Newman hopes you found this podcast useful in your journey of navigating senior care. 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Originally published June 16, 2018