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Differentiating Rona Bartelstone Home Healthcare through the Concierge Care Program
Increasingly consumers of home healthcare services are dissatisfied
with agencies that send out workers who do not fit the specific
needs of the care recipient and the family. For this reason Rona
Bartelstone Home Healthcare developed the Concierge
Care program to deliver a platinum level of care to clients
who want the best possible service. The best way to illustrate
this program is to describe an actual patient and the interventions
he received.
The initial phone call was received from the patient's wife, who
requested 24 hour care for her husband living in an assisted living
facility (ALF). Mr. Young (not the real name) was 72 years old
and was described as "having difficulty with orientation, not
wanting to be alone, and needing help with toileting." His diagnosis
was Lewy Body Dementia with Parkinson's features. The Concierge
Care program was discussed with Mrs. Young because of her
anxiety about meeting her husband's needs and her prior unsatisfactory
services from another home healthcare company. As usual the first
step was to have the care manager meet with her and her husband
to assess the needs.
The care manager found Mrs. Young very overwhelmed and distressed about meeting all of her
husband's needs. Although she did not live in the ALF, she was there daily for many hours,
despite having a job. Mrs. Young was struggling with her grief and her desire to have everything
perfect for her husband, therefore her stress level was very high. Furthermore, she was
apprehensive about leaving the care of her husband to the nurse's aides.
The care manager reassured Mrs. Young that the aides assigned to care for her husband would be
hand picked to meet his needs and would have knowledge about caring for a patient with this
type of dementia. The care manager provided reassurance and described how the care would be
individualized to meet her husband's needs. It was recommended that Mrs. Young also received
additional supportive counseling to help her cope with her grief, stress and anxiety.
The RN also assessed Mr. Young and made recommendations to Mrs.
Young about the care the patient should receive. Mr. Young presented
with some unusual symptoms. Initially, the patient walked with
a shuffling gait and was unable to answer any of the questions
on a mental status exam. Someone suggested to the nurse that she
ask the patient to "power walk" and when the nurse did this, Mr.
Young was able to walk perfectly without any shuffling. Later
during the nursing examination, he also was able to answer all
of the mental status questions that he couldn't answer the first
time, except for orientation to the date. Mr. Young was inconsistent
in his physical capabilities, his memory, and his moods. Despite
this, the nurse knew most of the aides and made her suggestions
for specific aides who would work well with someone who was unpredictable
in their needs and their ability to relate to other people.
The next meeting was to discuss the treatment plan with Mrs. Young
and introduce the team members. Present were the care manager,
the RN, and the CEO. The COO and the Director of Nursing (DON)
were also introduced. It was decided that Mrs. Young would come
to the office for counseling by a Licensed Clinical Social Worker
as she continued to be overwhelmed grief, guilt and anxiety and
was having difficulty working in the team approach because of
trust issues with the home healthcare staff.
Once the care began with Mr. Young, it became apparent that he
was depressed, tearful, anxious and sometimes aggressive. His
condition deteriorated rapidly and he was more frequently incontinent
of bowel and bladder and was urinating frequently. He was also
urinating in containers, on the floor and in inappropriate places.
The aides noticed this frequency and suspected a bladder infection.
The assigned nurse and the DON were informed. Mrs. Young was contacted
and Mr. Young was taken to his urologist.
At the same time, Mrs. Young was receiving counseling sessions that helped her to cope
with her anxiety and to limit her time with the patient in order to obtain some rest
for herself. It was also requested that she leave the patient in the care of the
aides when he was agitated and distressed. The nurse was in close contact with the
aides to assist them in dealing with any behavioral changes or concerns. Mrs. Young was
gradually building trust and allowed the aides to care for her husband. This was a
very difficult adjustment for her.
Throughout the care of this patient, there was constant contact between the nurses,
the aides, the wife, and often the psychiatrist and medical physicians. The aides
were given support and instructions from the Director of Nursing and the Staffing
Coordinator. The aides submitted a daily report about the patient's status to the
other team members to assure the coordination of care and support for Mrs. Young.
The counselor provided information and the team members shared and communicated care
planning ideas and focus. It was the team approach to care and communication that
enabled trust building and to develop a relationship with the patient and spouse.
Once again, this is the very definition of our Concierge
Care program that provides an enhanced level of services to
the care recipient and the family.
For more information on any of the above and how we can help you, please contact:
Rona Bartelstone Care Management & Home Healthcare
phone: 1.800.678.7224
email: info@rbacare.com
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