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Making Sense of Medicare Requirements for Home Care

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Receiving care in your home is often preferred over going to a facility to recover from a surgery or illness. It can not only be comforting to be in your own home while you recover, but it is also often necessary. If you have Medicare or another form of insurance, there may be questions you have about what your plan will cover. In order for Medicare or other insurance policies to cover home health care, there are generally four requirements that must be met.

  1. Care must be ordered and overseen by a physician.
  2. The individual must have been seen by a physician for the condition requiring home care no more than 90 days prior to the start of home care services or no later than 30 days after the start of home care services.
  3. The individual must be “homebound,” meaning that leaving the home to receive care is unsafe, requires the assistance of other people and/or requires considerable and taxing effort.
  4. The care needed is “skilled” and not “custodial”.

Skilled care is care that can only be delivered by a trained professional, such as the home health care professionals at Nightingale Homecare. For example, skilled care can include care for a complicated wound, or the development of a home exercise program to be implemented after a hip replacement.

Custodial care is care that can be provided by a non-professional. Generally, it is the help given to an individual to allow him or her to complete daily activities, such as bathing, dressing, preparing meals, eating, using the toilet, walking, etc. This type of care is not provided with the goal of helping someone heal from an illness or injury. It is provided to make sure daily activities are completed safely. While Medicare will cover custodial care given by a home health aide during the time that someone is receiving skilled care, ongoing custodial care is not paid for by Medicare.

The Arizona Department of Health Services can be a helpful resource for questions about what Medicare covers.

Many individuals require greater assistance than Medicare or other insurance providers will cover under the home health care benefit. They may need someone to be with them round-the-clock while they recover from an illness, or they may need care for a longer period of time than Medicare will cover – perhaps even until the end of life. In these cases, individuals usually utilize long-term care insurance policies to meet custodial care needs, or they pay privately for this type of care. For many seniors, the unlimited options provided by home care services is more preferable than going into the unfamiliar surroundings of an elder care community or facility.

If you’d like to explore senior care options for yourself or a loved one, the professional in-home care team at Nightingale Homecare is here to help you determine the best care solution for your specific circumstances. Providers of the highest quality home care Phoenix, AZ has to offer, Nightingale Homecare offers a full range of care – from custodial care to highly skilled nursing care and therapy services. Contact us at (602) 504-1555 to learn more.


Breathe Easier with These Oxygen Safety Tips

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Enhance oxygen safety with these tips.

Most of us seldom give much thought to oxygen. It’s an invisible, harmless gas that is all around us, ready to take in with our next breath. Even though it surrounds us in the air we breathe, concentrated oxygen delivered to those with health conditions can be dangerous, for two main reasons:

  • Oxygen can potentiate fires. Oxygen is itself not “flammable,” but it causes other things to catch fire at lower temperatures and burn hotter and faster.
  • Oxygen is considered a medication and it is possible to overdose.

Because of these two major dangers, special oxygen safety measures need to be followed closely. At Nightingale Homecare, we provide senior care Phoenix AZ families trust, and we assist those using prescribed home oxygen in staying safe by educating on and adhering to the following safety considerations:

  • Do not smoke around oxygen and keep away from open flame (candles, gas stoves).
  • Place “No Smoking” signs throughout your house.
  • Do not use appliances that could produce sparks while wearing oxygen (electric razors and hair dryers).
  • Do not cook while wearing oxygen.
  • Store cylinders on an appropriate stand and secured to the wall, or on their side on the floor to prevent tipping.  If they fall over and the valve comes loose, they can become a dangerous missile.
  • Store cylinders at room temperature, away from heat or direct sunlight.
  • Keep oils/petroleum products such as Vaseline away from oxygen.
  • Use cotton bed sheets and clothing to prevent static electricity and sparks.
  • Keep your oxygen equipment at least ten feet away from open flames and heat sources.
  • Keep at least 5 feet away from electric stoves or heaters.
  • Keep the service number for your oxygen equipment nearby, in case something breaks.
  • Do not store oxygen in an enclosed area, such as a car or closet. When traveling in a car with oxygen, always have a window slightly opened.
  • Do not store oxygen cylinders in the trunk of a car.
  • Do not cover oxygen tubing with bedding, carpet or furniture.
  • Do not allow children or untrained individuals to handle or operate oxygen equipment.
  • Make sure your smoke detectors are tested regularly.
  • Have a fire escape plan.
  • Do not leave oxygen on while not in use.
  • Do not use oxygen without a doctor’s order.
  • Don’t change your dose, except when prescribed by a doctor, since using too much or too little can cause serious health problems.
  • Regularly clean and maintain your equipment as instructed by the supplying company.

For more oxygen safety tips, or to arrange for a free in-home assessment to learn more about how our professional home health care team can enhance overall safety, comfort, and wellbeing for your senior loved one, call on Nightingale Homecare. As the top providers of senior care Phoenix AZ families rely on for expert, compassionate assistance, we’re available to help with a wide variety of needs. Contact us at (602) 504-1555 to learn more.


The Role of Your Home Health Care Team

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Discover the roles of each home health care team member.

You may have questions about the home health care professionals sent to your senior loved one’s home and the role that each one plays in his or her recovery. While not every senior will receive every type of service, allhome care professional services are ordered by the doctor who is overseeing care at home, and all professional home visitors will be in close communication with each other and with the doctor. Nightingale Homecare, providers of the top rated senior care Phoenix AZ families need, breaks down the details on each of the types of home health care professionals who may visit your senior loved one:

What is the role of the nurse?

If a registered nurse is involved in your loved one’s care, you can expect him/her to do a thorough review of any medications the senior is on, and provide instruction regarding those medications. If necessary, the nurse might organize medications in a medication cassette or “pill box” to make it easier to keep things straight. Nurses will also monitor and treat any wounds, change wound dressings if necessary, administer intravenous (IV) medications or certain injections, change catheters, help manage pain, and evaluate vital signs and disease symptoms. The RN will also teach the senior and family members how to provide self-care. Nurses play a big role in helping provide understanding of specific illnesses and how to best manage these illnesses to prevent hospitalizations.

What is the role of the physical therapist?

If a physical therapist is part of your senior loved one’s home health care team, she/he will evaluate how the senior is moving and functioning in the home and develop an exercise program designed specifically to help the senior regain mobility and function. Physical therapists can work on strength, mobility, balance and coordination. They also play a big role in looking at the home environment and making recommendations to prevent falls and injuries. They make sure the senior is using the correct mobility equipment, such as walkers or canes, and that the way the senior is moving around is safe. They teach both the senior and his or her caregivers how to safely transfer if help is needed in going between the bed and a chair. Therapists are also required to check vital signs to make sure the senior is well enough to receive therapy.

What is the role of the occupational therapist?

The occupational therapist will evaluate how the senior is doing with activities of daily living, such as bathing, getting dressed, getting meals and tending to the home. They take a close look at how any problems with movement, muscle weakness, sensation, vision, hearing, breathing and thinking might be affecting activities of daily living. They have a lot of knowledge about special devices that can make activities of daily living easier for those experiencing challenges. They also make recommendations for how minor changes at home, such as moving things around, can make activities of daily living manageable.

What is the role of the speech therapist?

A speech therapist will focus on problems the senior may be having with memory, problem solving, swallowing, speaking, and/or understanding speech. She/he will develop a personalized plan to address specific problems in these areas.
What is the role of the social worker? The social worker will evaluate whether there are any community programs or services that could assist the senior with any physical, financial or emotional challenges. Social workers are skilled at helping people cope with stress and improve difficult family situations. They are also very knowledgeable about different types of housing and how much support is available in different housing environments. They are available to help in figuring out how to plan for the future needs of someone whose health is declining.

What is the role of the dietician?

A dietician will look closely at the senior’s medical diagnosis, eating patterns and nutritional status. She/he will develop an eating plan that works for the senior and that follows any medical instructions. She/he will also help with planning meals and provide tips for shopping and cooking. Sometimes dieticians are called in to work with patients who have severe issues with weight gain or weight loss, diseases that affect their nutritional status or dietary needs, and patients that have to be fed through a tube.

What is the role of the home health aide?

Home health aides work under the strict direction of the nurse or therapist, following a care plan that is developed by the professionals involved in the senior’s care. She/he will help with personal care, such as bathing/showering and getting dressed and ready for the day. The home health aide can also tidy up after providing personal care and help with any exercises that the therapist has ordered. Home health aide visits are limited to the amount of time it takes to provide personal care services. Home health aide visits usually are provided one to three times a week, depending on each individual’s circumstances.  The number of visits your senior loved one receives is determined by Medicare criteria and will be explained by the nurse or therapist. If the senior needs more help than what the home health aide can provide under Medicare guidelines, Nightingale will be happy to talk with you about options to consider. We are experts with in-home supportive care services and have helped many people that are having difficulty managing at home.

We’d love to talk with you to share more details on how our full team of home health care professionals can work together to keep your senior loved one safe, healthy and thriving at home. As the top providers of senior care Phoenix AZ families rely on, Nightingale Homecare is here for you! Call us at (602) 504-1555 to learn more.


Navigating the Dementia Doctor Visit

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Make doctor visits easier for those with dementia.

Medical appointments, treatments and procedures can be stressful for all of us, but for those with dementia, the associated confusion and cognitive problems can make for an extremely challenging undertaking – both for the senior himself and the family caregiver accompanying him. Lots of questions and concerns may arise, and may continue to rise repeatedly as the senior tries to make sense of why and where you’re taking him.

At Nightingale Homecare, we provide the skilled and compassionate dementia care Phoenix area families trust, and want to help reduce stress and ensure that seniors get the most from their doctor visits. The following tips may help.

Before the Appointment

A little advanced thought and preparation can go a long way towards creating a smoother and easier experience at the doctor’s office. It’s a good idea to write down your questions in advance, rather than trying to remember everything when you arrive. Include in your notes a list of all current medications the senior is taking, both prescriptions and over-the-counter meds, as well as any changes or concerning symptoms you’ve noticed in your loved one. Note as many details as possible, such as dates, times, and frequency of these changes, and include your observations on such intangibles as the person’s quality of life and overall contentedness and wellbeing.

During the Appointment

It’s important to be mindful of the need to maintain respect for the senior at all times, refraining from talking about the person as if he’s not there or talking over him or for him if he’s trying to convey something to the doctor himself. The doctor should confirm with the senior that he’s ok with having you present during the visit. Ensure you fully understand the doctor’s answers to your questions and concerns, and don’t be afraid to ask for clarification when unsure about a response you receive. Be sure to take notes during the visit, and ask for a printout summarizing your visit as well.

After the Appointment

Update your records with any prescription, diet or activity changes recommended by the physician, and implement accordingly, continuing to take notes on your loved one’s condition until the next scheduled appointment. Additionally, and perhaps most importantly, keep in mind that in order to provide the very best possible care for your senior loved one, you need to take good care of yourself as well. Providing care for a senior loved one with dementia can quickly become overwhelming, and it’s easy to let self-care take a backseat; but serious health risks can arise in caregivers who neglect their own care.

The best solution for both the senior and yourself is partnering with a trusted, experienced dementia care professional, such as those at Nightingale Homecare, who can provide routine respite care services, allowing family caregivers to take much-needed breaks from care while knowing their loved one is in skilled and compassionate hands. As a top provider of the dementia care Phoenix families trust, we can also provide a higher level of assistance, all the way up to and including full-time, live-in care – which is particularly helpful in effectively managing some of the more challenging aspects of dementia care, like sundowning, aggression, wandering, and more.

Contact us at (602) 504-1555 to learn more about our specialized Connections Dementia program or any of our other in-home care solutions for seniors.


Prevent the Spread of Germs with These Handwashing Hygiene Tips

Prevent the spread of germs with these tips from the best senior caregivers at Nightingale.

Being in close personal contact with our senior loved ones is all part of providing care for them, but it also increases the risk of sharing bacteria and viruses. At Nightingale Homecare, we’re dedicated to keeping seniors safe, healthy and well by doing our best to prevent the spread of germs, and the best way to accomplish this is through effective handwashing techniques. As elementary as it may seem, keeping hands clean through good handwashing hygiene is one of the most important steps we can take to keep our senior loved ones – and ourselves – from getting sick, as so many diseases and conditions are spread simply through unwashed hands. As a leading home care Phoenix, AZ agency, we’re pleased to share our top handwashing tips.

When to Wash Your Hands

  • Before and after caring for someone who is ill or presumed ill
  • After blowing your nose, coughing, or sneezing
  • Before, during, and after preparing a meal
  • Before eating
  • Before and after wearing gloves
  • Before and after caring for a cut or wound
  • After using the toilet
  • After touching an animal, feeding an animal or tending to animal waste
  • After touching garbage

How to Wash Your Hands

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them.

When You Don’t Have Soap and Water

Washing hands with soap and water is the best way to reduce the number of germs on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs and might not remove harmful chemicals. Hand sanitizers are not as effective when hands are visibly dirty or greasy.

How to Use Hand Sanitizers

  • Apply the product to the palm of one hand (read the label to learn the correct amount).
  • Rub your hands together.
  • Rub the product over all surfaces of your hands and fingers until your hands are dry.

Want more tips to help prevent the spread of germs, or additional resources related to providing the highest quality level of care for your senior loved ones? Call on the home care Phoenix, AZproviders at Nightingale Homecare! We’re always happy to help families improve quality of life for the seniors they love and offer a full range of personalized in-home care services to ensure older adults can safely age in place where they’re most comfortable: at home. Call us at (602) 504-1555 any time to learn more.