Articles of Interest


Do You Have the Right Care Plan for your Senior?

You’ve taken the time to carefully choose a home care agency to provide the support your loved one needs to stay in their own home. Your Mom seems happy with the services and caregiver. But, is she getting the right home care services to address all her health conditions and personal concerns?

As every aging adult has their own set of health issues and needs, each should receive individualized care that addresses their particular situation. That’s where a care plan comes in. A care plan is a written document that outlines specific tasks to address your senior’s specific needs. Developed by the home care agency prior to providing care, the care plan serves as a guide for caregivers to perform certain activities when visiting the home of your special senior. It also ensures family members, health care providers, and your parent(s) are in sync with care expectations.

Assessing Needs

A senior home care plan begins with a geriatric assessment that evaluates a person’s functional abilities and living situation including:

  • Health and physical condition
  • Mental state
  • Performance of daily living activities such as bathing, dressing and cooking
  • Home (is the living arrangement acceptable or need some changes?)
  • Social network and access to support services
  • Functional limitations
  • Existing and anticipated problems

The home care agency uses information gathered from the assessment to develop a comprehensive care plan that outlines services recommended for the client. To ensure greatest acceptance by all involved parties, the care plan is developed in collaboration with the family and client, taking into consideration their preferences, goals, and care expectations. As seniors age, preferences and routines in daily activities remain important. At the same time, family members may have goals such as improving a parent’s nutrition and adding exercise to the day. A joint collaboration is best for everyone to support the care plan.

Designing the Care Plan

 

The home care plan lists tasks and how frequently a caregiver must execute them. They can include:

  • Personal care/grooming
  • Household chores
  • Meals
  • Medication management
  • Permitted activities

Below is a sample of a senior home care plan. This form is very simple and outlines basic activities such as personal care, food, activities and household/transportation tasks. Other care plans may be more detailed and include sections on how to care for seniors with advanced health issues. A copy of the care plan is typically left in the client’s home and filed with the agency for easy reference.

Care Plan Benefits

The care plan helps the caregiver get organized and prioritize activities by outlining a daily timeline of tasks. It ensures tasks are completed without anything mistakenly left undone to deliver the best client care. Families also know what to expect from the caregiver on a daily basis.

In addition, the care plan ensures the safety of both client and caregiver as only assigned tasks are completed during home visits. Caregivers understand not to conduct tasks not listed on the care plan without prior approval from supervisors. The family or client should contact the agency to make additions or changes to the care plan as the caregiver does not have authority to perform tasks outside of its scope. While it is important for seniors to make decisions about their care, caregivers must follow a confirmed written care plan and not deviate from it. At the same time, your parent can make realistic suggestions about daily activities that they would like to change or add.

Clients are asked to sign off on care plans. Periodically, supervisors visit the home to ensure the satisfactory completion of tasks according to the care plan by the caregiver. Documentation of completed tasks also ensures everything is completed within designated timeframes. Information is shared with families to verify tasks are completed on schedule, especially for those who don’t live near their aging parents. Using the documented care plan as the basis for discussion, the home agency can discuss services with the family. Regular communications are important, especially with families distantly located from loved ones.

Updating Home Care Plans

As seniors needs change, the home care agency should review and update the care plan to address them. Ongoing client monitoring by a caregiver often is the first notification of a change. For example, a caregiver may notice subtle changes in your parent’s physical or mental condition such as moving slower or becoming unsteady. Your loved one also might tell the caregiver of new ailments such as body aches. An updated care plan should address these changes, providing updated directives to the caregiver.

Should your maturing parent experience a health event, a care plan should reflect the new levels of care needed to support the individual in recovery. A loved one’s progressive medical condition also may dictate more frequent reassessments. Someone with a progressive condition like COPD or dementia needs more frequent assessments than a person with more stable health issues. In fact, Medicare requires home health agencies that provide skilled care to review each client’s care plan at least once every 60 days.

Quality care means getting the right home care services that addresses the changing needs and preferences of your loved one. The care plan ensures that your aging parent’s needs are met with services that addresses their current situation. It’s important to become familiar with the plan and stay involved with updates so that your aging parent always receives the right home care services to maintain a high quality of life.


For advice on different ways to stay involved, read Be Proactive, Stay On Top of Your Elderly Parent's Care.


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