Home Care Agency News

Lorince Care Services, LLC dba ComForCare Home Care Achieves Accreditation with ACHC

Somerville, NJ, Lorince Care Services, LLC dba ComForCare Home Care announce today it has achieved accreditation through the Accreditation Commission for Health Care (ACHC) for services.

Accreditation is a process through which healthcare organizations demonstrate compliance with national standards. Accreditation by ACHC reflects an organizations's dedication and commitment to meeting standards that facilitate a higher level of performance and patient care.

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Caring for a Family Member with Dementia During the Holidays

By Nancy Lorince, Managing Director

"For age is opportunity, no less than youth itself... And as the evening twilight fades away the sky is filled with stars, invisible by day." -Longfellow

We are so accustomed to seeing age in terms of loss, we sometimes overlook the fact that it brings unexpected gifts as well.  But caregivers of elders with dementia often tell me that, along with the challenge caregiving brings, come moments of real connection, warmth, and joy.

The fall and winter holidays are full of sensory and emotional content that create opportunities for sharing such moments with loved ones with dementia.  Steeped in tradition and repetition, holidays trigger long-term memory, an area where many dementia patients still have capability.

Below are some suggestions to engage all five senses of your loved one with dementia during the holiday seasons.  These activities can bring you both pleasure and a chance to connect.

• Smell - The sense of smell is strongly connected to memory.  Don't bake the pumpkin pie without taking a few moments to smell the ginger, cinnamon, close and nutmeg together with your loved one.  Talk about memories associated with these secrets.
• Taste - Recruit your loved one as your taste tester.  Do the cranberries need more sugar?
• Touch - String garlands of cereal to put out for the birds, or roll balls of cookie dough together.
• Sight - Look at photos from holidays past, or sort fall leaves by color.
• Hearing - Music is stored in a different part of the brain than other memories and retained longer.  Even those with very advanced dementia may be able to sing holiday songs with you.  Or listen together to the sizzle of latkes in hot oil or the sound of the fire in the fireplace.

Higher functioning dementia patients may be able to help stir a batter, set the holiday table or put bows on packages.  Just remember to give only one direction or task at a time.  Most dementia patients cannot manage a task requiring two or more steps without being prompted with verbal or visual "cues."

Always thank your loved one for his or her help - even if some batter gets spilled or the bows all end up on one package.  You can always fix things later, but it's harder to repair hurt feelings.  Most dementia patients have had a lifetime of being useful and productive.  They don't lose the sense of satisfaction that comes from helping others.

Don't be distressed if you try an activity only to find that your loved one doesn't respond or even dislikes it.  Like all of us, dementia patients have preferences that should be respected.

Remember, too, that although they need sensory stimulation, dementia patients don't always process it as others do.  Too much noise, even too many family members talking and laughing at once, can be disorienting and cause anxiety.  Similarly, too much clutter can be visually confusing.  Be sensitive to signs that you need to simplify and avoid sensory overload.

The various brain disorders we lump under the generic term "dementia" do indeed rob people of many abilities.  But creating the highest quality of life for these patients requires us to focus on what remains rather than what is lost - the capacity for pleasure, for joining in activities and for making emotional connections with others.

Make Each Day Count - Building on Positive Interactions in Dementia Care

The American Journal of Public Health reports that Americans are living longer and are in better physical health in old age than ever before.  New treatments and better knowledge about how to manage chronic conditions are making a real difference.

Unfortunately, longer lives mean that dementia associated with advanced age now have more time to appear.  While only about 7% of people age 70 to 79 exhibit dementia signs, the incidence for those over 90 years old is 37%.  Dementia poses a real challenge for family and professional caregivers alike.

While Alzheimer's is the most common form of dementia, it is only one of several different types.  It is important for a person showing symptoms of dementia to receive a comprehensive evaluation by a geriatric specialist.  Treatment and management of symptoms can vary depending on their cause.

While medical science seeks ways to prevent and treat dementias, those of us who work day-to-day with seniors have also been learning a great deal.  New understanding of what it feels like to live with dementia is transforming our approach to caring for those patients and helping them live fuller, happier lives.

An approach known as "habilitation therapy" is now considered a best practice in dementia care.  It focuses on creating positive emotional experiences for dementia patients and engaging them in meaningful activities.  It reminds us that dementia patients never lose the ability to experience a full range of feelings and that, like all of us, they need to have some control over their daily lives.

If someone with Alzheimer's or another dementia is part of your life, here are a few tips you can use right away.  These approaches can head off problems before they begin and help you and your loved one make the most of your time together.

• Emotions are contagious.  If you are tense, rushed or annoyed, the patient will perceive that immediately and react to your emotional state.
• Let go of any instinct to correct or argue with a dementia patient.  It almost never works and it just causes frustration!
• Build on the abilities your loved one retains to engage and interest her.  She may still be able to fold clothes, set the table or help with simple cooking tasks.  Feeling useful is a great morale booster.
• Dementia can affect depth perception and make small, busy patterns on carpets or tablecloths confusing.  Visual simplicity and clear color contrasts help patients navigate and manage daily tasks.  For example, it's easier to see a fork resting on a sold color placement than on one with a floral pattern.
• Dementia also affects peripheral vision.  You may startle an Alzheimer's patient if you approach him from the side.  Objects and people need to be directly in front of the patient and at or near eye level to be seen clearly.

These are just a few of the techniques we are training our home care aides to use to make each day with their dementia clients as happy as possible.  Please call us at 908-927-0500 if you would like to receive a copy of ComForcare's 12 Tools for Effective Dementia Care.  We would be happy to send you a copy.

Supporting Patients at a Critical Time

Last week reminded me how even the best hospital care can be undone if patient's don't get the right help after discharge.

One of our 87-year-old clients, Mrs. T, was inspired by warm weather to do some ambitious spring cleaning - overambitious, in fact.  She managed to drag the furniture away from the walls and move some heavy lamps.  She was taking down curtains when she fell hard and fractured her shoulder.  When our home care aide arrived to prepare dinner for Mr. and Mrs. T the ambulance was just pulling away.

The hospital took fine care of Mrs. T for three days, and the plan was to transfer her to a rehab center for a couple of weeks of physical therapy.  So Mrs. T's husband was shocked to get a call telling him she was coming straight home instead - an in less than two hours!

Medicare wouldn't pay for a longer hospital stay or for rehab, so back home was the only option.  Regulations didn't take into account that there was no family nearby to help or that the patient's spouse was 90 years old.

Mr. T wanted to take great care of his wife, but trekking up and down stairs with her meals was really hard, and he wasn't much of a cook anyway.  Poor eyesight and some memory loss made deciphering the hospital paperwork challenging.

When my RN and I visited them the next morning they were both exhausted after a bad night's sleep.  It was clear we needed to get them extra hours of home care, but just as important was coordinating the follow-up care.

There were no instructions in the discharge papers about how to care for the bruised, swollen shoulder.  Ice?  Heat?  More it or keep it immobilized?  The paperwork said a visiting nurse and therapist would come, but when we called the service they had not received the information about Mrs. T and nothing was lined up.

Fortunately, we were able to make calls, get the needed information and set up the proper follow-up appointments.  We are happy to do this kind of care coordination not only for our regular clients but also for anyone who needs a hand making a successful transition from hospital to home.

Our home health aides transport patients home, pick up prescriptions and groceries and help people settle in.  Our RN reviews discharge instructions and educates patients about maintaining their health in the home environment.  She makes sure needed equipment is delivered and coordinates follow-up care with doctors, nurses, and therapists.

Hospitals do an amazing job healing injury and illness.  Our job is to help patients continue the path toward health and independence once they are home.  If you would like to learn more about our Hospital-to-Home Transition program or about ongoing home care services, please call us at 908-927-0500 or see our website.

No Place Like Home

Successful Hospital-to-Home Transitions for Seniors

By:  Nancy Lorince, CSA

"Hospitals are no place for sick people." writes geriatrician Dr. Mark Lacks in his book, Treat Me, Not My Age.  His statement is especially true for seniors.

Older patients face many risks during a hospital stay.  Lack of sleep or new medications can cause confusion.  Too much bed rest leads to weakness, and being catheterized can cause lasting incontinence.

"As many as 75% of hospital readmissions are preventable."

But the biggest risk often occurs when a patient returns home.  In 2009, the New England Journal of Medicine reported that 1 out of 5 Medicare patients wind up back in the hospital within 30 days of discharge.  Even worse, the study found that as many as 75% of these hospital readmissions are preventable.  They are caused by poor care coordination and lack of ongoing support after discharge rather than the original health diagnosis.

ComForcare Home Care is a leader in addressing the challenges facing seniors after hospitalization.  Our Transition of Care Program starts before clients leave the hospital and continues after discharge.  The goal is to preserve health gains and reduce unnecessary hospital readmissions.

ComForcare RNs educate clients about their health conditions and discharge instructions.  We ensure prescriptions are properly filled, the needed medical equipment is delivered and that follow-up appointments are made.  If transportation from hospital to home or to follow-up appointments is needed, we provide it.

For patients who need more assistance to be safe and comfortable while they recuperate, our Certified Home Health Aides provide many services, including bathing and grooming, ambulation assistance, medication reminders, meal preparation, and shopping.

Clients with chronic health problems, such as congestive heart failure, diabetes, hypertension or breathing disorders, can benefit from our Chronic Disease Management Program.  Here, too, education and coaching help us empower clients to manage their conditions to maintain health and well-being.  We teach them to monitor their health and recognize "red flag" symptoms before they become a serious problem.

Most seniors want to remain in their homes and live as independently as possible.  Our goal is to provide the support they need to achieve their goals.  Families are welcome to call us at 908-927-0500 anytime to learn about our services or other community resources available to help seniors achieve quality of life in the setting of their choice.

Whether your loved one needs assistance only a few hours a week or around-the-clock, our team is happy to help! Call (908) 927-0500 to learn more about the transition care services offered through ComForCare Home Care (Somerset County, NJ).