By Mark Friedman, Owner, Senior Helpers
Last month I wrote about the long-term systemic challenges the pandemic has created with regards to professional caregivers – specifically, the impact of a greatly reduced workforce, an increased inability of caregivers to make a long-term commitment to cases, and the economic impact of increased wages and other costs associated with health care and aging in place.
This situation is both intense and ongoing. In addition to posing the fundamental challenge of who will provide the care and can we afford it, there is also the need for a smart path forward to navigate the challenges.
The first step is to have a holistic, proven and consistent method of assessment to determine the right care. The second step is to understand that “the right care” will change, thus requiring the assessment be performed on a regular cycle to monitor changes and to adjust the care accordingly.
So what is a “good assessment?” Many professional publications have referenced the term “person centered care” over the years. However, they have not done a great job of defining exactly what that means in simple terms – most definitions focus on high level objectives but there is a debate as to whether there are eight principles, or four principles, etc.
Let me define it as follows: Person centered care is crafting and delivering a plan of care that is:
If these are the standards, then the assessment must enable this to happen. Based on 20+ years of research and 75,000 plus case studies, the Senior Helpers’ Life ProfileTM meets and enables these standards of patient centered care.
The Summer 2022 issue of the Journal of Aging Life CareTM shares the Life ProfileTM research-based strategies for preventing risks that lead to hospitalizations for seniors. The article, “Stop the Revolving Door of Hospitalizations by Keeping Seniors Safe at Home,” examines the importance of Micro Social Determinants of Health (mSDOH) in identifying key outcome areas for keeping seniors safe wherever they call home.
This assessment is built on a complete understanding of the root cause of why seniors experience hospitalizations, and how patterns emerged in these distinct categories:
• Safety – A full assessment of the 144 safety risks (Task, Individual and Environmental) that can impact an individual’s ability to age in place.
• Medical Condition Management – Review of the seven specific obstacles to success.
• Autonomy and Independence – Status and needs to ensure the 13 basic living needs of an individual are met (ADLs and IADLs).
• Caregiver Support – review of the potential impact of caring for another.
• Quality of Life – it is not enough to just survive; the focus must be on thriving through active engagement in everyday life.
While the article’s focus is on reducing hospitalizations, the impact is successful aging in place. This defines a complete assessment of an individual’s needs. It is this level of completeness that translates status to a risk score that an individual’s success can be orchestrated and a complete plan of care can be defined. In short, the same approach can be used to prevent admissions or other unforeseen events and craft a plan to age in place.
So what is complete? A complete plan of care is a 24-hour care plan. It addresses the safety risks identified, defines the deficiencies, strategies and techniques to meet the 13 life needs; and addresses the requirements to track, manage and fulfill the needs for medical condition management. The plan reviews the impact of burden, identifies strategies for success, and identifies and tracks life engagement to ensure that an individual thrives.
Lastly, it creates a partnership in the circle of care – professional, family, the individual, and the community, making certain to ensure all are aligned and work as a team. Tracking of the assessment scores over time identifies improvement trends and impairment trends so focus and attention can be adjusted accordingly.
This level of completeness is what ensures financial and time resources across that circle are respected, not being wasted. This is “Right Care.” This is how a family can meter their investment in care and ensure it is both impactful and successful in addition to balancing financial and time constraints.
If you want your loved one to be successful in their journey of aging, insist on a proven, evidentiary based approach to defining their care and keeping it on track over time.
Next month: How smart technology can provide insight, support and economic leverage to the structure of care.
About the Author: 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 hightouch caregivers. And secondly by becoming a significant connection for elders to resources and services in the 75 communities his company serves. Please visit: www.SeniorHelpersSouthShore.com or contact Mark: MFriedman@Senior- Helpers.com. ∞