Circle of Friends Case Management

2013 Strategic Plan

Circle of Friends (COF) Case Management is committed to providing quality case management services for Elderly Waiver consumers. As part of that commitment, it is our desire to share our vision for the future.

Please review the summary of our strategic plan listed below. After reviewing the plan, we invite you to share your ideas, suggestions by e-mailing us at info@cofhomecare.com.

Vision Statement

COF Case Management was developed when few other Elderly Waiver case management agencies existed.  This allowed our agency to capture a large number of current Elderly Waiver clients who may be dissatisfied with the lack of options, slow response times, large caseloads and minimal face-to-face contact with their case manager.

Mission

It is our mission to provide consumers with community resource information in order to allow them to remain safe, in their home, with all needs met for as long as possible.  We will strive to remain highly knowledgeable of and maintain a positive rapport with all providers in our area.

Values

COF Case Management program falls under the umbrella of a fully established home health care agency.  This allows our agency to provide a lower staff to client ratio than our competitors, decreasing response times and increasing client satisfaction.  In addition, clients who utilize both our home health and case management services will benefit from increased coordination of care.

Objectives

-       To provide a choice to Elderly Waiver consumers in case management services.

-       To compliment the services already offered by Circle of Friends Home Care in order to allow consumers to receive all coordination of cares through one location.

-       Improve service delivery – faster response times

-       Keep clients informed of all available resources

Strategies

Circle of Friends will market our strategy of lower client to staff ratios, faster response times and a “face with the name” approach to the case management staff.  Many clients feel like “just a number” to their caseworkers and some do not even know who their caseworkers are.

Goals

1. Maintain CARF accreditation in 3-year increments (CARF accreditation allows us to provide case management services for the elderly waiver program)
2. Focus on low cost marketing strategies to elderly waiver clients who may be dissatisfied with their current services.
3. Maintain client to staff ratios of 50-75 clients to ensure that service quality does not suffer.
4. Remain highly knowledgeable in community resources

We encourage you to e-mail us at info@cofhomecare.com with any suggestions or ideas on additional supports you would like to see us provide, things we are doing well and/or areas of improvement.

Did you know that the average senior takes two to seven daily medications?
As we age our bodies change, affecting the way medications (and foods) are absorbed, distributed, metabolized, and excreted.

All of these can create a greater risk of drug interactions and side effects.
The more medications the care-receiver takes daily, the easier it is lose to track of how many to take and when they should be taken.

Caregivers should use a medication organizer for their care-receiver.
Consider these other tips:
1. Make sure all of the care-receiver’s doctors and specialists are aware of what the other is prescribing. Good communication is extremely important.

2. Make sure you understand how and when to take all of your medications.

3. Select over-the-counter products to treat only the symptoms you have. Follow-up with the pharmacist to make sure there will not be a reaction with other medications you are taking.

4. Make sure all medications are clearly labeled.

5. Keep medications in their original containers.

6. Never take medication in the dark or poor lighting.

7. Know what your medications look like. If it doesn’t look right or same, contact the pharmacist before taking.

8. Only take the amount prescribed for you.

9. Never take someone else’s medication.

10. Follow the directions on the container. Do not stop taking medication just because you feel better. Call the pharmacist when in doubt.

11. Use a medication organizer.

12. Don’t store medications in sunlight or direct heat. Store medications properly.

13. Never store medications in the bathroom. There’s too much moisture there.

14. Use whatever means you can to help your loved one take medication properly.

15. Don’t carry medicines next to your body. That can raise the temperature and cause some medications to break down.

16. Always get your prescription filled on time so you don’t run out. Missing even one day can make a difference in the effectiveness of many medications.

17. Use one pharmacy for all your medicines. This will help ensure that you don’t take conflicting medications.

18. If you have any questions about your pills, make a note to remind yourself to ask your doctor or pharmacist.

19. Tell your doctor if you have any side effects.

20. Be sure to tell your doctor or pharmacist of any herbal preparations you are taking. Some herbals can interact with prescribed medications and cause them to be less effective.

21. Know the names and doses of the medicines you’re taking.

22. Keep all medicines out of the reach of children.

23. Throw away any medicines that aren’t currently prescribed to you.

24. Ask your pharmacist’s advice before crushing or splitting tablets. Some should only be swallowed whole.

Did you know that drug misuse is one of the top problems that doctors see in seniors? Did you know that about 320,000 questionable prescriptions are written for seniors yearly?
Almost 40% of all drug reactions each year involve seniors. Be responsible. If you have any medication questions be sure to ask your pharmacist.

According to several recent studies, over 1/3 of falls at home occur in the bedroom, and most home fires originate in the bedroom. The majority of fatal fires occur while the residents are sleeping. Since the elderly spend about a third of their time in the bedroom, it is extremely important to correct bedroom safety hazards and take preventive measures to help avoid potentially life-altering disasters.

• Lighting: Provide a light which is easy to operate within comfortable reach of bed . Install a light switch at entrance to room. Use nightlights, especially in pathway from bed to bathroom. Have a working flashlight and your eyeglasses at the bedside.
• Walkways: remove all clutter, electrical cords, phone cords and protruding furniture from pathways, especially from bed to bathroom. Remove throw rugs or secure to floor with double sided tape.
• Bed height: Adjust bed to normal height for safe, easy access. To minimize dizziness, sit at the edge of the bed for a minute or two before slowly standing up.
• Communication: Install bedside telephone and attach list of emergency numbers in large print.
• Provide sturdy chair with arms for dressing and sitting activities.
• Install working smoke alarms on every level of home and immediately outside of bedroom.
• Never smoke in bed and do not use candles! Smoking in bed is the number one cause of fire in seniors’ homes.
• Close the bedroom door when you go to bed. If there is a fire, this will slow it down.
• Avoid going to sleep with a space heater operating, as this is the number two cause of fire in seniors’ homes.

Besides the above environmental issues, there are other ways to help minimize your risk of falls at home:

• Stay active physically; walking for exercise is an excellent way to keep your lower extremities strong and improve balance. Your neighborhood senior center may have exercise classes for stretching, strengthening and balance. Check with your doctor before beginning a new exercise program to be sure it is okay.
• Avoid alcohol, especially if you are taking medications.
• Keep your mind active: Doing crossword puzzles, reading, playing cards and board games with friends are all great ways to help keep you oriented and more equipped to deal with everyday issues and emergency situations. There are even programs available in the marketplace which can significantly improve your memory and mental acuity, leading to greater independence and safety.

It doesn’t take much modification to significantly reduce risks of falling and fire in the bedroom. It could mean the difference between remaining independent versus requiring long term care or succumbing to premature death.

Medicare Open Enrollment

Circle of Friends Home Care and Circle of Life Hospice want to make sure all of our clients know their rights in regards to the Medicare Open Enrollment Period coming soon.  Medicare’s annual enrollment period will begin October 15 and continue through December 7. During this time, Medicare Advantage and Medicare Prescription Drug Plan providers may solicit Medicare participants to change their Medicare plan.  Circle of Friends Home Care is committed to ensuring that Medicare participants make an informed choice that will best meet their needs.  Before joining a plan, you should understand the type of plan you are joining.  Some plans may have restrictions that may limit your options in health care providers, add additional co-payments for services you frequently use and other benefit changes you may not want.  Your local SHIIP (Senior Health Insurance Information Program) representative can provide the necessary information to assist you in making an informed choice. Lucas County residents may contact Lucas County Health Center Volunteer Services at 641-774-3226 to schedule an appointment with a SHIIP representative.  Additional information may also be found at www.shiip.state.ia.us.

There are specific guidelines that insurance providers must follow when marketing their products. They may not solicit enrollees door-to-door or in common areas like lobbies or hallways. They cannot make unwanted calls, or leave voicemails, state they are calling on behalf of Medicare or that Medicare asked them to call. To report concerns of specific complaints about inappropriate marketing practices, please contact CMS (Centers for Medicare / Medicaid Services) 1-816-426-5783.

If you have questions or concerns about your Medicare plan or health care options, feel free to contact Circle of Friends Home Care at 641-774-2339.

Caring for the Elderly by Preventing Falls By : SeniorsList.com

One bad fall for an elderly individual can lead to serious problems that require a hospital stay, loss of independence, lengthy rehabilitation, or worse. This is why it is so important to remain proactive in decreasing the risk of falls. There are several methods for reducing the risk of falls. Take on a comprehensive fall prevention plan so that you or your loved ones will stay safe.

Improve Strength and Balance

Many elderly individuals and their families reduce the physical activities of the elderly person as a safety precaution. Unfortunately, lack of activity is actually a leading cause of falls. Healthcare professionals now encourage the elderly to remain as active as possible through a variety of physical activities. Regular exercise is important for strength, balance, stamina, proper walking gait, and quicker reflexes. Those who live sedentary lifestyles are far more susceptible to falling than those who make exercise a regular part of their lifestyle. Choose a physical activity that is suited to a person’s mobility. Many elderly individuals benefit greatly from low-impact exercises such as swimming, yoga, and walking.

Activities that stimulate the brain are also important in order to improve reaction time. Games or activities that are mentally stimulating exercise the brain in a way that can help to keep elderly people sharp and mentally focused on the tasks at hand, which could save them from a dangerous fall.

Safeguarding the Home Environment

Elderly people who live at home should carefully assess their home for potential dangers that may cause falls. For instance, if a throw rug is constantly presenting a problem for an elderly person, you could consider tacking it down or removing it altogether. Individuals with very limited mobility should live in one-floor units or should only use the first floor in order to prevent dangerous falls.

It’s important to look at a home from the perspective of someone who cannot easily navigate uneven surfaces or who is susceptible to slipping. For example, a bathtub may not be suitable for a person who finds it difficult to lift their legs up and into the tub. Attempting to do so on a daily basis is likely to lead to a fall eventually. A shower setup with a non-slip mat may become a necessity.

Assess Medications and Medical Conditions

If an elderly person reports feeling dizzy or confused, the cause may be a medication or a medical condition. For instance, there are drugs that have side effects that make individuals more susceptible to falls. When drugs are used in combination, there can also be undesirable side effects. Talk with your doctor to find out if the side effects you are experiencing could be caused by your medications or a medical condition. They may be able to come up with a solution that will reduce your risk of falling from dizziness or other side effects. By making a careful assessment of what may be causing unsteadiness in an elderly person, you can begin to take steps toward reducing the risk of falls.

Circle of Friends Home Care likes to share information and articles that give insight to the community on many of the topics and tough choices we help our clients and their families with on a daily basis.  I came across this article from  seniorslist.com recently and thought I’d pass it on.  In the article the writer gives some tips for finding care for aging parents when you and your siblings don’t necessarily agree on the best route.  I thought there were some very good ideas and points in this article.  Here is the article:

Difficult Decisions Written By : Lisa Machado

Difficult Decisions
When Siblings Do Not Agree On How to Care for An Aging Parent

As an owner of a senior home care agency, my heart goes out to those adult children who are in the midst of a difficult decision regarding aging parents. I am often on the receiving end of phone calls where the caller, a son or daughter of an aging parent, expresses some concern over the fact the siblings do not agree on how to solve the problem of Mom or Dad needing some assistance with activities of daily living.  (These tasks are often referred to as “ADLs”, and they include bathing, dressing, preparing meals, ambulation, bathroom assistance.)   One sibling may want in-home care, while another may want Mom or Dad to move to assisted living facility and yet another sibling may want Mom or Dad to sell the house and downsize.

Recently I met four siblings, each wanting a different solution.  They were quite frustrated.  After listening for a bit, it was clear they all had great respect for their parents.  Each adult child wanted to do the “right thing.”  They just disagreed on what the right thing was.  I pointed out to them they had already successfully completed several steps of a very difficult decision making process:

• Each recognized they needed to do something.  This, in itself, is a decision.
• Each had a true desire to help their parents.
• Each felt no entitlement to their parents property or money as a future inheritance.
• Each had spoken to their parents about their concerns – “planting the seeds”  of   needing to adapt to health changes.
• Each  began to gather and share care solutions and were now formally meeting, as a family, to discuss.

This family is well on their way to finding an appropriate solution for their parents.    The steps above plus the following may prevent unnecessary conflict among siblings:

1. All the facts should be gathered. Use the Internet and local advertisements to gather information about home care, assisted living facilities, nursing homes and retirement communities.   See advice of professionals but be careful of those companies who may be biased and or direct you to a solution where they receive financial compensation for a specific recommendation.
2. The wishes of the parents should be considered. Regardless of the health of your parents and their mental ability there are certain desires that should be respected if they have shared these with family members and/or have written them down.  Often solutions can be combined so that some, if not all of their wishes, can be met.
3. Financial status of parents and extended family needs to be evaluated. Your and their financial status may narrow down your options.  But be sure to investigate any hidden costs with any solution.  Also, keep in mind,  your parents “rainy day” money (money that the parents have saved) should be used on providing them comfort in their final years not saved for future inheritance.
4. The health of the parent(s) needs to be evaluated. Current health conditions need to be considered but also certain future situations should be prepared for (ie.  loss of mobility).
5. The location and wishes of the siblings. Not everyone may be perfectly happy with the solution, but is it one that they can at least try?  It is possible one solution may be good temporarily to see if it works?  How can remote siblings help the siblings that live locally to the parent?  How can the local siblings share responsibilities to prevent resentment later on.

I  tell my kids that their sibling disagreements are quite normal.   We are supposed to be different with different ideas and perspectives.  The trick is to respect each other’s opinion and to try not to say or do things to each other that cannot be “undone.”

It’s not much different with us as adult siblings (except we may be more set in our ways!).  We need to come up with solutions in a way that includes ideas, concerns and feelings of those involved and those that care.  As circumstances change, so may the solutions need to change.  It is an ongoing process and we will need to be flexible enough to change with it.  But, hopefully it will be one that leaves us with the peace of mind that our parents were well cared for in their final years.

Diabetics Exercise Caution

If you have diabetes, it is essential to begin and maintain an exercise routine. A health care professional must first evaluate you for symptoms that could be aggravated by particular activities. You might also undergo a cardiac stress test.

Why Exercise?
Exercise is part of a well-established health regimen for people with diabetes. Dr. Ronald J. Sigal, who studies the long-term trends of the illness, reports in a 2004 Diabetes Care article that increased activity is associated with prolonged lifespan, enhanced lung function, and decreased accumulation of dangerous fat coating the abdomen. Sigal defines “increased activity” as exertion equivalent to walking briskly approximately two hours and fifteen minutes per week.

Increased activity also lowers bad cholesterol, raises good cholesterol, stabilizes blood pressure, enhances the effectiveness of insulin, improves mood, and boosts self-confidence.

When is it Safe To Exercise?
Managing your blood sugar is crucial to a safe exercise plan. You should check it before, during, and after your session. A test thirty minutes before you plan to begin will indicate whether exercise is safe. If your glucose level falls below 100mg/dL, try a piece of fresh fruit or whole grain crackers, but do not exercise until it reaches the 100 to 250mg/dL range. Blood sugar elevated beyond 300mg/dL is too high for exercise. Symptoms of high blood sugar (hyperglycemia) include: excessive thirst, frequent urination, blurred vision, and dry skin. You must not exercise in this instance, because your sugar levels could continue to escalate. You might be able to lower your sugar using prescribed medications. Consistent adherence to your exercise plan will contribute to lower blood sugar over time.

During exercise, watch for symptoms of hypoglycemia, a blood glucose level of 70mg/dL or lower. If you feel shaky, nervous, irritable or confused, if you develop a hand tremor, or if your skin becomes cold and damp, stop exercising. Take glucose tablets, drink four ounces of fruit juice or sugared soda, or eat several pieces of hard candy. Recheck your glucose in 15 minutes. Have another snack if necessary. Repeat the process until your blood sugar level is above 70mg/dL. You can resume exercise when your sugar level is stable. Continue to monitor it closely several hours after you finish.

Protect Your Feet!
You must also take special care of your feet when you exercise. If you have diminished sensation in your toes and feet, and/or poor circulation, you are especially vulnerable to injury and infection. It is therefore important to choose proper footwear. A protective exercise shoe features ample toe room, a removable, flexible insole, a sole that cushions the ball of the foot, and a stabilizing, firm heel. Since exercise places extra stress on your feet, you must be vigilant for signs of injury. Do daily checks for cuts, sores, swelling, and infected nails, both before and following exercise. Wiggle your toes for five minute sessions, once before and once after exercise. If your feet are severely affected by neuropathy, try seated activity. Chair-based stretching and strengthening enhances everyday functioning, and in some cases seated exercise leads to an increased activity level.

Know Which Exercises are Beneficial
Knowing which activities to avoid is as important as identifying the beneficial ones. Isometric Exercises for example, could put you at risk if you have high blood pressure, eye problems or damaged blood vessels. Isometric movement also potentially aggravates vascular conditions. Avoid activities requiring heavy strain but minimal movement.

Just as diabetes compels you to modify your diet, it also requires you to approach exercise differently. Be mindful of these guidelines for your safety and comfort. Do not allow your symptoms to discourage you from staying active!

Thanks for visiting our new site.  We hope you like it and would love to hear your feedback on it.

Jake Schroeder -  Billing & Marketing Director