In the News

The Benefits of Dementia Care in Home Care

McKnight’s Home Care / By Lance A. Slatton 

Caring for individuals with dementia presents a unique set of challenges, as the disease progresses through various stages, affecting memory, cognition and behavior. While some may believe that institutional care is inevitable, many experts and healthcare professionals advocate for home care as a viable and often preferable option. Keeping people with dementia in their homes for as long as possible offers numerous benefits, from maintaining familiarity and comfort to enhancing their quality of life.
 
The importance of familiarity for dementia patients
 
One of the greatest advantages of home care for those with dementia is the familiarity of their environment. Dementia patients often experience confusion and anxiety when their surroundings change, making home a crucial anchor for their well-being. The American Medical Association highlights that “aging in place,” or remaining in one’s home, is often the best option for dementia patients, as it helps them maintain a connection to their environment and routine, which can slow cognitive decline and reduce behavioral symptoms.
 
The familiar surroundings of home allow individuals to retain a sense of independence. For example, knowing where essential items are stored or simply recognizing the layout of their home can help reduce the risk of accidents and panic that often arise in new, unfamiliar settings. Moreover, remaining in a familiar environment minimizes the disorientation that can result from transitions, such as moving to a nursing home or memory care facility, which could exacerbate confusion.
 
Tailored, person-centered dementia care at home 
 
In-home care allows for highly personalized, one-on-one attention that is often difficult to achieve in institutional settings. Caregivers in a home environment can design care plans tailored to the unique needs of the individual. For instance, home care providers often offer services ranging from medication management and personal care to meal preparation, ensuring that the person’s specific health and lifestyle needs are met.
 
This approach fosters a more intimate, ongoing relationship between the caregiver and the patient, something that is hard to replicate in more crowded care facilities. Additionally, in-home care enables caregivers to adjust their approach as the patient’s condition changes. Dementia care coordinators, for example, can visit homes regularly to assess safety concerns and adapt care plans to the evolving needs of the individual. In contrast, care in a memory care facility might not always offer the same level of personalized attention due to higher staff-to-patient ratio.
 
Reduced hospital stays and better health outcomes
 
Studies have shown that individuals with dementia who receive care in their own homes tend to have better overall health outcomes. For instance, a study by Johns Hopkins Medicine found that patients who received regular in-home care from dementia care coordinators were less likely to move into nursing homes or experience hospitalization than those without such support. This preventive model of care not only enhances the quality of life but also reduces the stress on both the patient and their family.
Furthermore, patients often thrive when their care is administered in a comfortable, low-stress environment. Home care allows them to continue familiar routines, like spending time with pets, enjoying home-cooked meals, or engaging in familiar hobbies, all of which contribute to their overall well-being…

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Help the Care at Home Community Impacted by Hurricane Helene

NAHC Report

Hurricane Helene has severely impacted the southeastern United States, with many lives already lost in the Carolinas, and countless missing with no means of communication. Some of the most hard-hit communities are located in North Carolina and South Carolina. Throughout western North Carolina and the Midlands and Upstate regions of South Carolina the devastation caused by Hurricane Helene is still being assessed. President Biden has now declared 25 Western Counties in NC, plus the Cherokee Nation, as Federal Disaster Areas. President Biden has declared 13 counties in SC Federal Disaster Areas, as well.

The Carolinas Foundation for Hospice & Home Care is accepting donations to distribute directly to hospice and home care employees devastated by this storm. Agencies are facing tremendous challenges, including displacement and/or evacuation of staff and patients, collapsed roads, failing infrastructure, lack of water, and the inability to communicate with downed lines. There is a major need for gas to continue to power generators for oxygen dependent patients both in home settings and hospice inpatient facilities.

The Association staff has been in contact with government agencies to us keep up-to-date on the situation as it unfolds.

The care at home community is comprised of caring, compassionate individuals who help those in need. Please consider donating to the Hurricane Helene Relief Fund to help home care and hospice employees hit the hardest.100% of ALL ADMINISTRATIVE COSTS are being borne by the Association and the Foundation. 100% of your donation (tax-deductible) comes in, and 100% of your donation goes out.

Donations may be individual or corporate, and as a 501(c)3 organization, they are often tax deductible based on an individual’s tax status. Please share this information with anyone you think would like to contribute.

Impacted members can also apply to receive funds through the National Hospice Foundation’s Workforce Emergency Support Fund to assist in needed repairs. Please reach out to [email protected] with any questions.

The Alliance is prepared to help support our members in the path of Hurricane Helene. Members can access the Emergency Preparedness webpage in the Regulatory & Compliance Center for helpful tools and guidance.

All of us at the National Alliance for Care at Home are thinking of all our colleagues, agencies, patients, families, and communities impacted by Hurricane Helene.

GO HERE to donate to a Hurricane Helene Relief Fund for the Carolinas

 

Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings Rulemaking

Occupational Safety and Health Administration

. . . On August 30, 2024, OSHA published in the Federal Register a Notice of Proposed Rulemaking (NPRM) for Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings. This is a significant step toward a federal heat standard to protect workers. The proposed standard would apply to all employers conducting outdoor and indoor work in all general industry, construction, maritime, and agriculture sectors where OSHA has jurisdiction. The standard would require employers to create a plan to evaluate and control heat hazards in their workplace. It would clarify employer obligations and the steps necessary to effectively protect employees from hazardous heat. The ultimate goal is to prevent and reduce the number of occupational injuries, illnesses, and fatalities caused by exposure to hazardous heat.

OSHA encourages the public to participate by submitting comments. Your input will help us develop a final rule that adequately protects workers, is feasible for employers, and is based on the best available evidence. The NPRM is available on the Federal Register web page at https://federalregister.gov/d/2024-14824 and at www.regulations.gov, which is the Federal e-Rulemaking Portal. You may submit comments and attachments electronically at www.regulations.gov, Docket No. OSHA-2021-0009. Follow the instructions online for making electronic submissions. Comments must be submitted by December 30, 2024. When submitting comments or recommendations, commenters should explain their rationale and, if possible, provide data and information to support their comments or recommendations.

All comments, including any personal information you provide, will be placed in the public docket without change and, with the exception of copyrighted materials, will be publicly available online at www.regulations.gov. Therefore, OSHA cautions commenters about submitting information they do not want to be made available to the public or submitting materials that contain personal information (either about themselves or others) such as Social Security Numbers and birthdates. All comments and submissions are listed in the www.regulations.gov index; however, some information (e.g., copyrighted material) is not publicly available to read or download through that website. All submissions, including copyrighted material, are available for inspection at the OSHA Docket Office. Contact the OSHA Docket Office at 202-693-2350 (TTY number: 877-889-5627) for assistance in locating docket submissions.

For more information on how to provide comments at this stage of the process, visit https://www.osha.gov/laws-regs/rulemakingprocess#v-nav-tab2.

See fact sheet at https://www.osha.gov/sites/default/files/publications/heat-rulemaking-factsheet.pdf

 

The Growing, Troublesome Issues Around Non-Solicitation Agreements In Home Care

Home Health Care News / By Audrie Martin

In August, Comfort Keepers was fined $500,000 and forced to remove language from its contracts restricting caregivers from accepting positions with home care clients up to one year after terminating employment.

That contract language, dubbed a non-solicitation agreement, is a widely used clause in home care contracts to protect providers’ businesses.

On its end, the Irvine, California-based Comfort Keepers is a large franchise that offers non-medical in-home support, including meal preparation, companionship and personal assistance.

The company required each client to execute a care agreement containing this language before receiving services. California Attorney General Rob Bonta concluded that this agreement violated California law by restraining worker mobility, as caregivers could not be hired by any Comfort Keepers client, not just the client to whom they were assigned to provide services.

In a statement issued to Home Health Care News, Comfort Keepers wrote, “We value Comfort Keepers caregivers, who are the heart and soul of each of our franchises and the Comfort Keepers brand. “As a service-based company, the quality of our care is rooted in the dedication and expertise of the caregivers who serve as employees. We invest significantly in their development to ensure the success of our services, the satisfaction of clients and the wellbeing of the caregivers. While this investment comes at a cost, we believe protecting the caregivers who become invaluable to our clients through their training and expertise is essential. Comfort Keepers is not seeking to limit or restrict any employee’s ability to earn a living; rather, we believe in a business’s right to protect its assets, ensuring the continued excellence of the care we provide.

Comfort Keepers maintains that direct hire provisions do not hinder workers from finding future employment. These provisions are designed to provide service-based businesses with compensation when the care recipient elects to hire a caregiver vetted, background-checked and trained by the agency in the form of a reasonable amount for the placement services it provided.

This is standard practice with service-based businesses across many industries. Furthermore, this is part of a larger and evolving issue being scrutinized by the U.S. Chamber of Commerce.”

Angelo Spinola, home health, home care and hospice chair at the Polsinelli law firm headquartered in Kansas City, Missouri, was involved in the case and told HHCN he thought the attorney general was incorrect in his position.

“They are applying a law that applies to non-compete agreements with employees to a client service agreement,” he said.

Non-compete and non-solicit agreements

In general, Spinola said that restrictive covenants are divided into confidentiality, non-compete and non-solicit agreements. These agreements are based on state laws, and certain states limit their use.

Non-solicitation agreements in home care are meant to prevent clients from hiring a caregiver directly and cutting out the agency. These agreements protect the agency’s business without restricting the caregivers’ mobility, providers believe. If the contract is violated, the agency may seek legal action and sometimes request damages…

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House Committee Greenlights Telehealth, Hospital-At-Home Extension Bill

McKnight’s Home Care / By Adam Healy
 
The House Energy & Commerce Committee approved a bill Wednesday that would extend important flexibilities benefiting telehealth and hospital-at-home providers.
 
The Telehealth Modernization Act of 2024 would grant two-year extensions to various telehealth flexibilities originally implemented during the COVID-19 pandemic. These include continued payment for virtually furnished care services, the elimination of in-person or geographic requirements for telehealth providers, and support for audio-only telehealth, among others. Currently, these flexibilities will expire at the end of 2024.
 
Telehealth stakeholders have pointed out that these services are especially beneficial for people who have chronic conditions or mobility-related challenges. In a statement Wednesday, the American Hospital Association applauded the House committee for its approval of the bill.
 
“We appreciate the committee’s commitment to ensuring that essential telehealth flexibilities are extended so that patients continue to receive access to high-quality care,” AHA stated. “The expansion of telehealth services has transformed care delivery, expanded access for millions of Americans and increased convenience in caring for patients, especially those with transportation or mobility limitations.”
 
The Telehealth Modernization Act would also extend the hospital-at-home waiver, which also began during the pandemic, by an additional five years. Hospital-at-home programs have grown and thrived in recent years, and providers that offer home-based acute care services tout high rates of patient satisfaction and roughly equivalent care quality as traditional inpatient care. 
 
However, a Medicare waiver supporting these programs is also set to expire Dec. 31. AHA also noted that its extension would be worthwhile for many home-based providers.
 
“Over the past few years, hospitals and health systems have expressed the need for long-term stability within the hospital-at-home program,” AHA said. “Standing up a hospital-at-home program requires logistical and technical work, with an investment of time, staff and money. In addition to being approved for the federal waiver, some providers must navigate additional regulatory requirements at the state level. For some, this whole process could take a year or more to complete before the first patient can be seen at home.”

 
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