DorlandHealth

The specialized services of Visiting Angels

Today, more than 7.5 million Americans receive home care services. In light of demographic and political trends, that number is expected to rise significantly in the coming years. While the Obama administration has pointed to longterm care with a decreased bent toward institutionalization as a thematic focus, the sheer number of Americans approaching the breakwater age of 65 will result in the need for increased services.

Home care, which can range from custodial-based to skilled nursing to hospice, is a common choice of consumers, many of whom require a basic custodial, or nonmedical, type of care provision.

Marie Kenny, a mother of two from Bowie, Md., found herself facing such a situation. Her father was impacted by spinal stenosis and debilitating back pain. Kenny, who works full-time, and other family members had become his primary caregiver, but the work was not easy. He required full-time help to get through the day. Listening to the radio one day, Kenny heard an ad for Visiting Angels, a home care service company headquartered outside of Philadelphia, and she made an exploratory phone call.

“I talked to them and they were very responsive,” she says. “They took the time to understand our situation and explain the services as well as the cost.” Obtaining this information allowed Kenny and her family to develop a plan of care and grant the family peace of mind. “They even followed up with a phone call to see if our situation had changed and to see if they could help us,” she says.

While Kenny has not yet made a decision, she was thrilled with the treatment she received, and at the time of this publication she is trying to sort out a dilemma faced by thousands of Americans every day.

To understand how a home care agency like Visiting Angels can ameliorate such a dilemma, Editor in Chief Anne Llewellyn sat down with two company executives — Chief Operating Officer Pat Drea and Vice President of Operations Karon Austin — to talk about the company, its care providers, and the state of home care today.

Can you explain the role private duty agencies play in the continuum of care?

Chronic health problems, acute health crises, or difficulties in handling tasks such a cooking a meal, toileting or keeping the house tidy will eventually challenge most older adults. Many adults and seniors with significant physical or cognitive impairments live at home and will need additional care and support. When they do, many will prefer to receive services in the comfort of their home. In addition, many adults and seniors can be discharged earlier from the hospital or the rehabilitation center when private duty services are arranged. For many in this group, assisted living, a nursing home or a retirement center is more than they need at this time; and yet complete independence isn’t realistic, either. When family members are also care providers, we arrange care around their schedule. When physical therapy, skilled nursing or hospice care is needed, we collaborate with those providers and often remain when other provider’s services are no longer needed. With 79.6 million baby boomers entering the ranks of retirees, the demand for supportive home care services will increase dramatically over the next several decades, and consumers as well as health care providers will look to private duty to provide for this population. The current number of private duty companies, estimated at 20,000, is likely to grow to meet this demand.

What do care providers and those who manage care provision and transitions need to know about aging and long-term care in today’s climate?

In today’s caregiving climate, seniors are living longer than in past generations. Seventy-five percent of caregiving is initiated by someone other than the care recipient. Ultimately, caring for a parent, spouse, sibling or partner is a responsibility many of us will face in our lifetime. When this challenge arises, integrating it into our busy lives can be difficult. Transitioning into a primary caregiving role is simply not a feasible option for most families.

Many options are available to us in the continuum of care. Studies have shown that we all want to remain in our homes for as long as possible. Statistics have shown that quality of life is greatly enhanced when care is provided to us in our homes. Caregivers in the home also prevent the social isolation that can occur as we grow older and provide the necessary socialization needed to prevent further declines in health.

What are the effects of the diverse confluence of factors on the so-called sandwich generation?

Unlike our parents, daily life is pulling us in 100 different directions at any given moment. Contemporary society’s pressure to produce has increased our dayto- day stress levels. We all want to make the best life we can for ourselves and our family. Therefore, we’re more aware of the effects crucial decisions like providing caregiving have on us and our parents. Knowing that in-home caregiving has a multitude of benefits for the care recipient provides greater peace of mind for everyone.

What are the basic services provided by a home care agency like yours?

Visiting Angels provides personal care such as bathing, assistance with dressing, hygiene, toileting, meal preparation, medication reminders, routine housecleaning, companionship and asssitance with errands. Our care recipients are able to choose their own caregiver, and we remain available for customer telephone inquiries after-hours with a 15 minute response time.

Can you describe a typical patient? In other words, one who is well-suited for your services?

Honestly, we don’t think there is a “typical” client. Visiting Angels customizes its services to fit the needs of each individual client. We provide services to adults within a wide age range. Many of our care recipients are 65 years old and up. The fastest growing segment of the population in our country is the 85 and older demographic. Some of our clients are younger adults with disabilities or in need of assistance during a recovery period from illness or injury.

Visiting Angels provides nonmedical supportive services. This differentiates us from physician-ordered services provided by home health agencies and hospices.

Can you share the steps you take when hiring staff, the training they go through, and the oversight private duty agencies provide to ensure safety of consumers?

We understand these concerns and conduct a comprehensive screening and training process for each of our caregivers. To make sure our staff is qualified, potential caregivers undergo two formal interviews and an in-depth background check. Potential caregivers must also have appropriate certification and experience. The Visiting Angels “select your caregiver” signature is invaluable. Our care recipients meet with the caregiver assigned to their care prior to commencing services. Making sure our clients select the caregiver that best suits them is crucial.

Is there a normal amount of time your caregivers spend with a client — in terms both daily and longitudinally?

There really isn’t a norm when it comes to caregiver time. We customize the time our caregivers spend with clients based on each individual client’s needs. How do your services help caregivers who bear the burden of caregiving?

Visiting Angels can work in conjunction with the primary caregiver to provide respite services. If you need to go out of town or simply schedule a golf outing a few times a week, one of our caregivers will make sure the care recipient is receiving the attention he or she needs.

We ask the client and the client’s family to guide us on what relief they need each week. The client is in control.

In general, does insurance cover your services?

Insurance policies specific to long-term care will cover services that provide ADL (activities of daily living). Some insurance policies will cover ADL in relation to long-term memory impairment, for example. What advice do you have for consumers on how to prepare for your service from a financial standpoint? What options are there for people who may have to pay privately for these services?

Call your insurance agent now and make sure your policy is updated. Look into long-term care and discuss with a financial planner. Family members of clients often share the cost of the care. Discussing the financial plan prior to the need for services (if possible) is always a good idea.

What oversight and licensing requirements do private duty companies have to meet? What type of surveys do they have to undergo?

Twenty-eight states have licensure for private duty companies for the purpose of consumer protection and the oversight of the provision of care. While these regulations vary from state to state, requirements may include a license application, substantiation that the agency carries liability and workers’ comp. insurance, evidence of policies regarding care, client supervision, caregiver training and credentials, proper handling and resolving of complaints, written service agreements, assessments and care plans. Many states arrange initial and ongoing surveys that last from half a day to three days to ensure the agency’s compliance with regulations.