From our guest columnist Caleb Johnson, of FirstLight Home Care of Deerfield/Lake Forest:
I got an urgent call recently from Maria, one of our caregivers.
Maria had arrived at the home of one of our clients – we’ll call him Roger. At age 86, Roger, who suffered from dementia, seemed to be stuck in his chair, unable to rise.
Roger is often confused. Since he is weak, part of our care plan is to help him ambulate whenever we go to his home.
Roger’s Wife Upset
But when Maria arrived, Roger’s wife Claudia explained that he had difficulty that day standing up. She spoke rapidly.
“He’s been babbling a lot today,” she said, shaking a bit as she held onto the back of a sofa in the front room. “And he doesn’t want to get out of his chair. I told him he should just be quiet and get some breakfast.”
Claudia seemed especially agitated this day.
Our caregiver was smart to call me.
I said, “Let me speak to Claudia.”
Call 911
Maria handed the phone to her. “You need to call 911,” I said. “Roger is not responding to anything. There could be something serious going on.”
“I don’t see why we have to go to that trouble,” she complained.
“I know that you don’t want to go to the hospital,” I acknowledged, softening my voice. “But, Claudia, I’ve seen this kind of problem before. Your husband could be in serious trouble. The paramedics will know just what to do,” I pleaded with her.
Claudia finally gave in and made the call. The EMS came, checked his vitals and took him away on a gurney.
We found out that he had pneumonia. Since we were able to catch it in its early stages, he was given an antibiotic. Thankfully, he was home the next day.
I know from past experience that if we had waited longer, he would likely have developed major pneumonia. That would have meant that he’d have to stay in the hospital for a week.
Thus, Roger was saved from a lot of discomfort and trouble. And possibly from death.
In a follow-up call to her later, Claudia told me, “You were right about getting him to the hospital. It could have been much worse.”
Problem of Readmissions
If not caught quickly, Roger’s problem is the type that often contributes to the difficulty of hospital readmissions. Nearly one-fifth of Medicare patients in this country have an acute medical problem requiring a further admission for treatment within thirty days of being discharged from hospitals, according to the journal BMC Geriatrics.
Readmissions are not good practice, I’m sure you’d agree.
CMS punishes general acute-care hospitals when more Medicare patients return for a new admission within thirty days of discharge than the government deems is appropriate.
Some common causes of readmissions are: medication errors, drug noncompliance by the client, failure to identify post-acute care needs, or inadequate nutrition.
Some of the most common problems we see here at FirstLight are that clients are dehydrating themselves, resulting in a UTI. And this could cause mental episodes, cognitive decline, or memory impairment. Or the seniors are more likely to fall and injure themselves.
Observation to Avoid Readmission
And there are other things we monitor. While physical therapy is typically given by healthcare providers only twice a week, or sometimes three, our caregivers observe their exercises every day. We also make sure that medications are taken regularly.
Everyone here on our FirstLight staff is well trained in all these practices. If you recall, in an earlier letter, I cut my eye teeth in home care as a teenager when I was compelled to become a caregiver for my grandfather, who had dementia.
Readmission is an important issue in our society – especially this year. President Biden used his State of the Union speech in February to announce a boost of nursing home standards.
So, it’s vitally important that patients be cared for.
It takes compassion, constant vigilance and a knowledge of signs of trouble – wouldn’t you agree?
When you think of providing your discharged patients with good quality caregiving, I’m sure you keep in mind:
- Taking blood pressure and temperature.
- Observing changes in behavior, or difficulty walking.
- Changing adult pull-ups when needed.
- Helping with difficulty in swallowing.
- Encouraging enough eating or drinking.
- Explaining conditions to EMT’s and medical personnel.
This is what our caregivers are trained for.
“Genuine and Refreshing”
Our clients praise our work. This is from Mark Snider:
“From the first call I had with Caleb, I found his answers to any questions I had to be very forthright, genuine and refreshing. When our final decision was made, he had already understood our general needs and just made it all happen!”
Will you put FirstLight at the top of your list when referring for home care?
The next time you need non-medical caregivers, whether at home or in a residential facility, call or visit FirstLight of Deerfield/Lake Forest at 224-880-6555. Our office is nearby in Libertyville, and we have caregivers in Lake County and northern Cook County.