The home care industry has grown rapidly over the last decade due to an aging baby boomer population and Americans’ general preference to “age in place” (or remain in their own homes). As new caregiver companies emerged in the Marina del Rey area and elsewhere, many worked to find ways to distinguish their services from others through improved or expanded offerings. Most notably, these have often included the addition of “case management” services and “Director of Nursing (DON) oversight.”
But as is sometimes the case with companies and their promises, savvy customers in Santa Monica and West Los Angeles must separate marketing messages from tangible benefits. There can certainly be overlap between the two but not always. Here are specific questions everyone should ask prospective caregiver agencies about their “case management” and “nurse oversight.”
1) Who conducts the start-of-care assessment?
While some home care agencies have a DON on the payroll, that person isn’t necessarily conducting new client assessments. In fact, many home care agencies rely on knowledgeable but unlicensed “representatives” to complete assessments or consultations. These folks are usually terrific resources who are passionate about their work. But realistically, there’s no substitute for a nursing license or clinical experience/education.
It’s important for families to remember that the person who conducts the initial assessment is also the one creating the “plan of care.” Different home care clients have different needs, and some are healthier and more independent than others. But it’s safe to say a care plan created by a licensed registered nurse (RN), as is the case with BrightStar Care Marina del Rey, inspires confidence and is especially critical for patients suffering serious ailments or cognitive decline (dementia or Alzheimer’s).
2) Does the Registered Nurse (RN) or Director of Nursing (DON) monitor every client?
As with new client start-of-care assessments, prospective home care clients should not assume an agency’s nurse or DON is providing ongoing oversight. He or she may simply be tasked with assisting clients based on case-by-case needs. So, their roles might be reactive and discretionary as opposed to proactive and universal. Some clients may benefit while others go unmonitored.
Ideally, a home care agency’s DON or RN will touch base with all clients in accordance with company protocols and as needed. This universal and scheduled approach ensures that resources aren’t limited to only the “squeaky wheels” and is the policy for BrightStar Care Marina del Rey. Such proactivity can help detect changes in disease progression and other medical conditions that might otherwise go unnoticed.
3) What is involved in your “Case Management”?
Case management (also referred to as “care management”) can be rather subjective. Again, some home care agencies may be reactionary in their approach, while others are proactive. Families seeking quality caregiver services should look for agencies with the latter philosophy.
Genuine, proactive case management means a licensed nurse will periodically visit all clients to assess their condition and review their plan of care. If the patient’s condition has changed, the RN will adjust the care plan accordingly. She may also recommend and help to schedule a doctor’s appointment for further evaluation.
4) Will your “Case Managers” or nurses coordinate other medical services, if needed?
As previously mentioned, a home care agency DON who conducts thorough case management sometimes discovers that a client’s condition has changed. In such an event, she may help to coordinate other medical services like doctors’ appointments. But the DON might also help in other ways.
For example, our BrightStar Care DON has personally coordinated the delivery of durable medical equipment (DME) for clients who find they need new or updated supplies such as hospital beds or hoyer lifts. She has even worked with pharmacies to secure picc line materials and has facilitated lab testing services from the comfort of the patient’s home.
5) Do you have licensed nurses to administer medications or assist with other medical needs like blood draws and wound care?
Many home care clients and families are shocked to learn that caregivers are legally prohibited from administering any medications in the state of California. And the definition of “administering” is all-encompassing and includes the oral delivery of medications in pill form. In fact, caregivers aren’t even allowed to fill pill boxes on behalf of their clients, as this task is considered “medication administration.” The laws are extremely strict and limiting!
Fortunately, agencies with registered nurse resources, like BrightStar Care, have staff who can legally administer medications. In fact, the DON actually reviews medications and manages the pill box during her start-of-care assessment. She even checks vital signs to establish a baseline for future reference!
Ultimately, most home care agencies provide valuable services that benefit the lives of millions of seniors across the United States. However, as with all industries, there are vast differences between companies. And for families seeking top-notch caregiver services, agencies with robust nursing resources--including proactive Director of Nursing oversight--are best equipped to deliver excellence. The key is to ask detailed follow-up questions to ensure the DON or RN on staff is actually utilized and not just talking point.
If you’re seeking the industry’s best home care services for a loved one or friend, be sure to call BrightStar Care of Marina del Rey today to schedule free RN assessment!