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September 2006
In this Edition:
New Beginnings After 9/11
Mr. Happy - Many Losses: New Beginnings
Things to Think About When Starting Private Duty Home Healthcare Staff
Congratulations Susan
Our Website Won a Design Award
New Beginnings After 9/11
by Rona Bartelstone LCSW, BCD, CMC, Chief Executive Officer
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As I think about the meaning of this date, I will forever have a knot in my middle for the overwhelming tragedy that is 9/11. The images remain fresh, the helplessness real. The righteous anger of the families of those lost is palpable. Yet to me, September has always had other meanings that are perhaps even more important now than at any time in the past.
September is officially the start of a new year in many ways. It is back to school time. It is return from summer vacations. It is the start of the Jewish New Year. It is the official start of "season" for those of us in southern tourist areas. It is an opportunity for something new to happen.
Being the eternal optimist that I am, September always seems like another chance to look at the cyclical nature of life and to try to make the most of the coming months and years. We can all think of things within our lives or within our own person that we would like to improve, change or build upon. Building upon our lives never has to end if we stay open to new possibilities. This is part of what is so rewarding about the work that we do.
In working with families, they honor us by opening their hearts and lives to us. While reaching out for help with some of the most intimate aspects of caring, families bring us into their midst and share history, relationship and culture. In doing this, they take on the challenge of creating change (and therefore, opportunity) within their family and within their own person. This is never an easy thing to do.
Since the process of creating change is not an easy one, it is often helpful to have a guide, a coach or a navigator along the way. When it comes to confronting the issues of age related illnesses or chronic disability, private care managers are often the best experts to turn to for guidance.
Our culture has emphasized the value of independence to the point that people feel as if they are lacking if they ask for help. Perhaps the truth really is that asking for help is a strength that enables us to accomplish more through the natural interdependence that exists throughout nature. My grandmother used to say, "Many hands make light work." How right she was!
How do you know the best hands to help with caregiving? Many articles have been written about how consumers can shop for individuals with the right credentials. While we support the idea of credentialing, perhaps there are other criteria that are just as important.
I am talking about the ability of the care management professional to engage in a relationship, the hallmarks of which are open communication, engendering trust and the presence of a connection or sense of chemistry that makes the caller feel more secure. Selecting a professional is a very personal process because it is part of the process of creating change.
Real change requires the ability to look at ourselves in ways that we may not have done before. This includes recognition of our strengths, roles and our coping mechanisms. A skilled care manager can help you to gain insight into the things that have worked in your relationships and to maximize coping abilities. Working together to navigate the path that is most consistent with your family's values, preferences and resources, the care manager will enter into a bond with you that will make the load lighter and more tolerable. The care manager will help you with insights about relationships that will have resounding impact on all of the ties in your life. This shared journey will enable you to maximize the connections and the strengths that every family has and will facilitate the process of new beginnings, no matter the place that you start.
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Things to Think About When Starting Private Duty Home Healthcare Staff
One of the greatest long-term needs of older adults with chronic illnesses is for in-home, custodial care,
which makes it possible for people with functional or cognitive limitations to remain at home in their
preferred environment. Home Health Aides and Certified Nursing Assistants provide the majority of this
type of care.
The three main types of private duty or custodial care companies in South Florida are:
- Licensed Home Health Agency - Non-Medicare Certified
- Licensed Nurse Registry
- Companion Company
Licensed Home Health Agencies and Nurse Registries often provide very similar staff to the consumer.
The primary difference involves the issue of who the employer and supervisor is for the staff.
In a Licensed Home Health Agency situation, the company is both the employer and the supervisor of
the care that is provided. This means that the care recipient has help in managing the nature and
quality of the care. In a Licensed Nurse Registry the employer and the supervisor of the care is the
individual who is the care recipient or a family member. This means that the consumer is also the
employer and the supervisor of the staff. A nurse may visit, but she is not allowed to supervise
the work of the aide because the aide is not their employee.
Companion Companies are not licensed, but they are registered with the State. Their staff is prohibited
by law from providing any "personal care" services. This means that Companions can only provide household
chores and friendly visitor/companionship services. The consumer must inquire to determine if they are the
employer or the company is the employer.
Why is this Important?
Consumers need to know that care decisions come with issues of legal liability and responsibility.
For example, if the care recipient is a private employer there are responsibilities imposed by the IRS,
which include:
- Withholding of income tax and your (employer) portion of social security and Medicare taxes
- Paying social security, Medicare and unemployment (FUTA) taxes
- Giving employee a Form W-2, showing the amount of taxes withheld from the pay (Click here to view form)
There may also be liability incurred for any injury that happens while the aide is on the job. Many people believe
that this is covered under their homeowners' policy, but this is not always the case and it would be necessary to
check with your insurance agent about your potential liability.
So the question to ask, when you need care to remain at home is, "Do I want the responsibility of being an employer,
or do I want to know that I have a team to help me?"
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Mr. Happy - Many Losses: New Beginnings
"Mr. Happy" despite the many losses in his life has been able to create new beginnings from some of life's most devastating tragedies. Mr. Happy is an 85 year old widower who lost his wife last February after a battle with cancer. They had been married for many years and had two daughters. In one of life's most cruel events, Mr.& Mrs. H lost one of their daughters at the age of 24 in a motorcycle accident. This was a terrible blow for the family, yet they persevered! Their second daughter is very close to her father however she lives 1500 miles away.
Mr. H. also has multiple ailments and was in the hospital with acute kidney failure when his wife passed earlier this year. Subsequent to his hospitalization, his only daughter helped him to relocate to a senior living community so that he would not be isolated after the loss of his wife. She also bought him a kitten to help with the transition into the new living arrangement. Despite the stand-offish reputation of cats, this little kitten is very attentive to Mr. H and actually seems to enjoy listening to his stories!
Mr. H's daughter engaged Rona Bartelstone Care Management to provide emotional support to her father to assure a successful emotional transition to his recent loss and to his new living situation. The Care Manager, Linda Gaibel is helping Mr. H through the grief process and facilitating a life review that is providing him with the opportunity to appreciate the joyful parts of his life, while coping with his multiple losses. Linda's relationship with Mr. H gives this devoted daughter peace of mind that he is not alone in this phase of his life transition.
One of the wonderful new beginnings that Mr. H shared with Linda was the rediscovery of a son from a prior marriage, from whom he had been separated for 50 years. A couple years ago, this son decided to search out and reconnect with his biological father. This "new" son also introduced Mr. H to his only grandchildren who are young teenage twins. As a result of this new relationship, Mr. H is able to experience the fulfillment of a relationship that he had been deprived of for most of his life. This provides a great deal of emotional satisfaction and joy to Mr. H.
At the senior residence, Mr. H is able to use his creative skills of jewelry making and repair, along with watch repairs to make new friends and find a place for himself within the social life of the building. He is hoping that in the future he will be able to teach jewelry crafts to other residents.
Mr. H. enjoys the ability to integrate the experiences of his life with the help of his care manager. He is able to keep his nickname of "Mr. Happy" because of his own personality and his ability to use the support of Linda Gaibel to transition into this new phase of his life, despite his many losses.
Once again, we are able to help those who come out of a tragedy to find a new beginning and try something new that buoys their existence from under life's hardships.
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Congratulations Susan
On September 14, Susan Fleischer, our Chief Operating Officer, was honored at the National Association of Professional Geriatric Care Managers (NAPGCM). She received the Adele Elkind Award, the highest honor that the association gives. Susan has dedicated her career to the advancement of professional geriatric care managers. She has made more than 70 professional presentations to across the country, imparting her knowledge and sharing her experience with others in the field. She has also had numerous leadership roles and currently serves as the president of the Florida Geriatric Care Managers Association. Congratulations, Susan, on this important achievement.
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Our Website Won a Design Award
As many of you have noticed, we have changed the look of our website. The site features a new design and easier navigation. We have also included even more useful information for our clients as well as our care management team. Our improvements haven’t gone unnoticed. I am very proud to announce that our website won an American Graphic Design USA award, a highly prestigious national award. |
