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If We Keep Seniors Front & Center, All we Can Do is Right.


By Mark Friedman 
Unknown-4October was Patient-Centered Care Month. This resonated with me because I often talk about seniors being the center of OUR universe here at Senior Helpers Boston and South Shore, and I was more than curious as to how our approach to caregiving aligned with the “patient-centered care” model popularized in the broader healthcare system.
What’s the scorecard? How do we measure up? Who’s keeping track? Why does it matter?
The term “patient-centered care” was originally coined back in 2007, a result of scores of focus groups, national telephone interviews of patients and families that created the “Picker” survey instrument. This measured the patient’s experience across eight dimensions of care, which became the Picker/Commonwealth Dimensions.
Once I discovered the involvement of the Commonwealth Fund in patient-centered care, I knew I (and you) should take notice. The Commonwealth Fund is a world class research institute and grant maker that funds domestic and international health care surveys, and national, state and local health care scorecards. It follows and influences policies and politics, and contributes to developing and reforming the likes of the Affordable Care Act and covering every hiccup on the Hill during the current healthcare debates. Let’s just say it is the “go to” authority on this topic of patient care.
When I set out to establish the highest standard of care for service for seniors in our care at Senior Helpers Boston and South Shore, I was unaware of the specifics of Picker/Commonwealth. Now, I do. The point is, do they matter?
The question is this: if these issues are important you, are you being well served by your home care company?  This is for you to determine, and for you to choose how to apply the standards for your choices in care providers.  I can respond on behalf of my agency.  You should obtain similar detail as you make your care choices.

  1. Do You Respect My Values, Preferences and Expressed Needs?

This seems like such a no-brainer, but it is not.
Learning to be a great listener is often an acquired skill. Understanding cultural differences and values requires training, sensitivity, practice and openness.
Often we first meet our seniors in their homes. We might spend an hour ”Getting to Know You” talking about favorite memories, meals, family trips and keepsakes around the Livingroom. We do this to learn as much as we can about personal histories, priorities, and interests.
Why? In order to make the best match of caregivers. This is not a random pairing, but a coordinated connection: part art, part science.  We know our caregivers are also life-givers and often become deep family friends and boon companions. We work hard to create these potential connections.
Being good listeners, matters.  HOWEVER, being good listeners does not translate to “blind following.”  We will all – providers and those in care – face tradeoffs between needs, desires, right, wrong, costs, etc.  What we want may not be what we need or even be appropriate. Your providers must be trusted partners in care to help you make informed choices – even the ones you may not want to make.

  1. Can You Coordinate and Integrate My Care?

“This is NOT what I expected for Mom’s companion”. We get that a lot.
As an increasingly viable option for aging in place, home care must respond to the complex physical considerations in which many seniors find themselves. Well trained caregivers are needed for seniors in different stages of Alzheimer’s, Dementia and Parkinson’s diseases. There are too many moving parts where these diagnoses are concerned; from coordination of diets, activities, exercise and medication regimens, to engaging family support. These require foresight and insight, a thoughtful approach to care management, and above all, a philosophy of care that is dynamic and inclusive.
At Senior Helpers Boston and South Shore we have built all of the above and work hard to bring these aspects of care and case management to our clients. Within our client-centric approach to care, every senior has a customized plan of care; a blueprint and roadmap. It begins with a nurse led intake and evaluation.  Each caregiver has two full days of supervised orientation and disease-specific training before being deemed “client ready”.

  1. Can You Keep Me Informed & Educated?

“The single biggest problem in communication is the illusion that it has taken place.” ——–George Bernard Shaw
You would think in this information age the healthcare system would have an unparallelled communications superhighway. Well, not quite.
While the concept of the Accountable Care Organization looked great in theory, its veracity is being tested every day because people are human and it takes humans to communicate, integrate, and coordinate.
Our proprietary “Going Home Safe” is a great example of information and education at work. A multi-dimensional program allowing seniors to recover safely at home, we play a significantly increased role in the chain of providers when it comes to preventing readmission.
We understand that discharge really starts at admission and we have a part to play when important decisions about recovery at home are being made while a senior is in the hospital or recovering in short term rehabilitation.
This is why we begin with client and or family education about home and exactly what the environment, care profie, nutrition, therapy, medication and follow-up medical care mean as it translates to a schedule and plan of care.
This enables the complete understanding of both the macro and the micro aspects of care critical to a successful recovery. It is also why we have a comprehensive Family WorkBook to engage loved ones fully in the recovery-at-home process.

  1. Do You Understand my Need for Physical Comfort?

Without comfort, there IS no care.
A sense of well being gives seniors their best days. We understand this comfort means being able to do the most they are capable of: from simple acts of bathing, dressing, and cooking, to things they simply enjoy doing. We empower seniors to do all they can because we know from deep experience the small and big activities that make them happy. This is our Positive Approach to care.
Every senior in our care is initially evaluated and routinely visited and monitored by a nurse. Every caregiver is nurse supervised and the chain of command and communications in our agency is purposely streamlined and lean. This gives us maximum flexibility to adjust to our seniors and what is going on in their home.
When we promise “care and comfort at a moment’s notice” we mean it. We are here 24|7|365.
Next month we will continue this conversation about the 8 Dimensions of Care responding to the next 4 standards you should think about when you make care decisions for yourself or loved ones.……….

  1. Do You Understand my Need for Emotional Support to Alleviate Fear and Anxiety?
  2. Do you Understand My Need for Involvement of Family and Friends?
  3. Can you Help Me with Continuity and Transition?
  4. Can You Help with Access to Care?

image001About Mark Friedman
Mark Friedman is the Owner of Senior Helpers Boston and South Shore. Passionate about seniors and healthcare, the goal of his agency is to set a new standard in home care in Massachusetts. First by delivering an exceptional home care experience in a combination of highly trained and high-touch caregivers. And secondly by becoming a significant connection for elders to resources and services in the 75 communities his company serves.
Reprinted from the November issue of South Shore Senior News