Setting Your Mind at Ease

As owner of Right at Home in Los Angeles, I’m on-call 24 hours a day/7 days a week. Even if another employee is taking calls during the evening or weekend, I know that they may reach out to me anytime if an issue arises beyond their authority to rectify.

Back in November, I took my first vacation in over 2 years. While still reachable, I was going to be outside of California. Although I had confidence in our employees, I was still nervous leaving them “on their own.”

As I thought about this, I realized my feelings of unease probably don’t compare to how family members of our clients feel when they leave their loved one alone for the first time with a caregiver. Yes, it’s true that Right at Home caregivers are trained and criminally background checked; covered by liability and worker’s compensation insurance; licensed and bonded. But that doesn’t assure they’ll bond with their family member in need of help.

From clients who’ve had the same caregiver for over a year to clients who’ve asked for a different caregiver literally every other day, we’ve seen it all. That’s why we always do an assessment when possible prior to placing a caregiver so we can meet the family, meet our prospective new client and select the best caregiver for their needs. And its why, even when on vacation, the owner of the company is always just a phone call away to address any concerns a family member may have.

As we exit the holiday season and enter into 2010, Right at Home will continue to do everything in our power to make sure your loved one is receiving the highest quality of care so you can be at ease while you’re away.

Veteran's Aid & Attendance Benefit

The Veterans Aid and Attendance Benefit is a benefit paid in addition to monthly pension. Benefits are available for Veterans and surviving spouses who require the regular attendance of another person to assist in bathing, dressing, meal preparation, medication monitoring or other various activities of daily living. This benefit is available to individuals who reside in assisted living communities, personal care homes, skilled nursing facilities and those receiving personal in-home care.

Any War Veteran with 90 days of active duty with at least one day during active War time (WWII, Korea, Vietnam, Gulf). A surviving spouse of a War Veteran may be eligible if he/she remained married to the Veteran until his/her time of death and has not remarried. The individual must also meet medical, service and financial qualifications.

Right at Home is committed to meeting the needs of those we serve to improve their quality of life. As part of our commitment, we want to make Veterans and their families are aware of this little known benefit available that can help them pay for care services. A veteran may be eligible for up to $19,728 a year, a Veteran with a dependent spouse may be eligible for up to $23,388 per year, a surviving spouse of a veteran may be eligible for up to $12,672 a year and two veterans married to each other may be eligible for up to $30,480 a year. Right at Home wants to connect Veterans with the people that can help Veterans qualify for these benefits.

If you want to learn more about the Aid & Attendance Benefit, call Right at Home at (818) 956-5905 or email info@rahglendale.net. We can get you in touch with the appropriate accredited claims agent to help you determine your eligibility and guide you through the process to help expedite your claim.

Happy Columbus Day!

It's been an unusually quiet day at the Right at Home Glendale offices today. I assume that probably has something to do with the oft-talked about, but not always celebrated holiday of Columbus Day.

So with a little extra time to take a breath today, everyone at Right at Home in Glendale would like to wish the hundreds...not thousands...no millions of readers of our blog a very happy Columbus Day and we look forward to a great last 2 1/2 months of 2009.

The Responsibilities of Ownership

A few years back while working at Game Show Network, we had a "Fire Drill." I don't mean that the fire alarm went off in our building and someone we worked with donned a green helmet and began directing us out while my co-workers slowly made their way to the stairs saying things that ranged from "A fire drill now, I'm in the middle of something due today." to "I hope it really is a fire so I can be off all week."

No, in business acumen, a "Fire Drill" is a fairly lame metaphor to describe a time when some sort of business "emergency" has occurred and everything you're working on needs to be dropped and all hands are called on deck to put out the "fire" of this particular emergency.

The fire drill I refer to had to do with a radio ad that was playing in Las Vegas that incorrectly stated that Game Show Network could be seen on Comcast cable, when in fact the cable company for the area was actually Cox cable. Due to a delicate relationship between Game Show Network and Cox at the time, this was more than just an unfortunate embarrassment and thusly a new radio ad needed to be created immediately and sent to the station that day.

So I called the owner of the production company that created the ad. I remember while speaking to him that there was a fair amount of noise in the background and hullabaloo all around. "Okay, okay," he said to me in a somewhat perturbed tone as I mentioned to him the problem. "I'm at the Dodger game right now, but I'll leave and we'll get something to you before 5pm."

The Dodger game, I thought to myself. I'd hate to be him. Buy those tickets, think you're spending a relaxing afternoon at the ballpark and then some schmo like me calls you up and makes you give up you're half-drunk, $11 beer just to re-record a 60-second radio spot. That's tough sledding.

Yet that's exactly the situation where I find myself today. Because at 3pm this afternoon, I too will be at the Dodger game. And this is no ordinary game, no mid-Summer Wednesday tilt against the lowly Pirates of Pittsburgh. This is a playoff game, against the slick pitching, high-powered Cardinals of St. Louis. And let me tell you, the last thing I want around the 3rd inning is a call from my office with the homecare equivalent of a new radio ad needing to be produced.

So what do I receive at 8am this morning. The "fill-in" caregiver (because the regular caregiver is on vacation) for one of our more difficult clients tells us minutes before her shift that she's got to go to the "emergency room" for an undisclosed illness and can't make her shift. I'll reserve comment on the legitimacy of the excuse, but thankfully our fine office was able to get another qualified caregiver over there and she arrived only a few minutes late. I commend both my office and that caregiver for their quick work.

Then, I receive another call at around 12pm from another client informing me that they need service at a different location than usual - some 48 miles farther away. When I inform them that we might not be able to send the same caregiver - who lives over 60 miles away from this new locale - they don't seem to quite understand why that is.

And first pitch is just 2 hours away.

Still, Right at Home here in Los Angeles is ready to go and certainly not depended on me to operate smoothly. My office staff is prepared, our schedules are set and we don't anticipate any issues for the rest of the day. Still, I full well know as the owner of this company that the buck stops with me...even if I sometimes wish the buck would stop with that other guy in row 9, seat 17 wearing the blue & white dodger wig.

But I made a promise to our clients. That one way or the other, we would always make sure a qualified, licensed and bonded caregiver will be there to take care of their loved one even if it means I have to stop what I'm doing and help tend to one our clients personally.

So, there will be no beer for me today and I'm prepared that my hot dog may have to be left behind half-eaten. But that's the deal I made and all in all, it's not so bad.

Oh, and by the way, GO DODGERS!

The Selling of In-Home Care

The "phenomenon" of in-home care is not new. There is no debate that the aging of the Baby Boomers certainly has everyone from their sons and daughters to Medicare Customer Service Reps bracing for the inevitable onslaught of care that is needed. It is a safe assumption that most people aren't going to want to leave their home to take up residence at an Assisted or Skilled Nursing community if they can help it.

However, there have been homecare agencies in Los Angeles that are 10, 20, even close to 30 years old. What has changed is the volume of home care agencies in Los Angeles and the abundance of choices families now have which no doubt at times probably seems more cumbersome than helpful.

As discussed in previous blogs, it doesn't take much of anything to start a homecare agency in the state of California as there is no separate license and no government regulatory agency overseeing it. The result of this is significant competition among homecare agencies for new clients.

At one point in an earlier life, I worked in television and for a while I was a sales rep at a cable network in a department called "Affiliate Relations." The job of a sales rep in Affiliate Relations was usually to convince a cable company (Comcast, Time Warner, Cox, and so on) to carry the cable network you were representing on their cable system. The people in charge of these decisions was usually the Vice Presidents and/or Directors of Marketing and while the launch of a new network on a cable system was of major importance to a sales rep like me, it was often times little more than an annoyance to the marketing person at the cable company.

To get these meetings, you'd call an assistant, maybe meet first with a middle manager or coordinator, and eventually beg, annoy, befriend and cajole the person long enough until you'd eventually get a meeting, which was usually a formal affair involving power point presentations, fancy, logo-infused pens and often times a not so cheap lunch or dinner.

Yet no matter how tasty the dinner, fancy the presentation or unique the gift, these cable marketing folk were fundamentally interested in one thing: How much would it cost them. And because of this, my retort often times focused on how we could offset, defray and even reduce those costs one way or the other. It's not that they didn't care at all about what the actual programming was on the network, but they were largely MBA's who'd spent long parts of their career in one organization often brought up to look at things in one very distinct, linear and "cover-your-you-know-what" way.

Now home care is a different business than cable television. First of all, it's largely a referral business. Only a small portion of your clients likely come by calling you directly after a Google search. Most will get your number from a social worker or case manager working for a medical or retirement organization. Yet any thoughts one might have of some "higher" call or moral standard that your average Hospital Case Manager, Nursing Home Social Worker or Hospice Nurse may possess are going to be disappointed.

You have a better chance of throwing a message in a bottle into the Pacific Ocean and getting a response than you do of calling and leaving a message for a Case Manager or Social Worker as a sales representative. Regardless of whether or not they're too busy or you're not deemed important enough is irrelevant.

The result of this is that a home care agency rep has no choice but to truly cold call. That is to say walk into a hospital or assisted living facility or wherever, and hope you can catch a wayward social worker, friendly physical therapist or wary case manager and pitch them your companies wares on the spot.

In addition, because the sales process is so informal and disorganized and there are so many different agencies (not to mention medical transport companies, durable equipment suppliers, and so on) coming in unannounced it forces you to go back again and again and again...and yes again so your agency can be remembered and, in theory, referred.

However, it is at this point where the similarities between these referral sources and our old marketing friends at cable companies begin to look alike. Because what do you think the number one question our account representative receive from social workers, case managers, discharge planners, resident care directors and the rest? Are you licensed and bonded? No. Do you carry liability and workers comp insurance? Nuh-uh. Do you background check your caregivers for criminal records? Hardly ever. Do you pay your caregivers a fair and legal wage? Not once.

Their number one question is almost always - "How much do you cost?"

Now I've always found this to be a rather startling question when you consider the source. Social Workers, Nurses and the like are educated people. They may or may not be caring people or compassionate people, they may or may not even be good at their jobs. But what they most certainly are not is financial planners. They seldom have access or a full understanding of a families financial situation or their personal beliefs on how money should be best spent. Therefore whether or not an agency is a "good deal" or "too expensive" is based on really nothing other than that individual nurse or social worker's personal perception and nothing at all to do with the family's perception or, far more importantly, their needs.

Please don't misunderstand me. Nurses and social workers, occupational and physical therapists, even hospital department assistants, are in the majority of cases decent people. They are often overworked, saddled with antiquated office technology and probably underpaid. But I bring this up to let you know that if you or your loved one find yourself in a hospital on the verge of being discharged and decide (or are told) you need extra assistance in the home, it's perfectly reasonable and a good place to start by asking for a list or brochures or reccomendations from your case manager or social worker. However, understand that those recommendations may be based not necessarily on the quality of the care or integrity of the caregivers that an agency can provide but rather on someone's personal perception of "value" or on someone's personal opinion of the agency sales representative or even on how often that agency brings gifts or food to their office.

So keep an open mind and be sure to ask the questions that are important to you. You probably wouldn't blindly take the advice of a car salesman when buying in a car and you should use a similar level of healthy skepticism when picking a homecare agency. By asking a few more questions of the agency at the beginning of the process may mean you have a lot fewer questions to deal with when caregivers are actually in your home.

Healthy Aging: Simple Lifestyle Changes Improve Quality of Life

A healthy lifestyle begins with small steps and setting achievable goals. Getting started is easier than you might think, even for the elderly. It is never too late for seniors to take control of their health and focus on the positive aspects of aging instead of the myths and negative stereotypes. With the right mindset, seniors can embrace growing older and start on the journey to healthy aging using items found around a typical home.

“Living life to the fullest as you age can be challenging, yet exciting. Making an effort to better your health can improve your quality of life greatly,” said Douglas Dickstein, President of Right at Home, a provider of in-home care serving the Greater Los Angeles area. “Awareness and education are important to empowering seniors to age gracefully.”

The following household items and activities can act as simple ways for seniors to begin their healthy aging journey.

Physical:
Before undertaking any type of physical program, seniors should talk to their doctor. There may be activities seniors should avoid due to personal health situations.

• A notepad and pen – Stay on track by writing down goals and recording your progress.

• Two cans of soup – Actually, any canned goods from the pantry serve as great hand weights and can be used help to improve arm strength. While sitting in a chair, place both arms out flat in front of you and lift the can up about six inches. Repeat five times. Remember, it’s not a race, start slow and increase your repetitions as you are able.

• Kitchen timer – Start with five minutes of exercise and increase time as ability warrants. Making slow, steady progress builds a routine and endurance.

• Glass of water – Among other health benefits, staying hydrated can prevent temporary memory impairment. Try to drink at least six to eight 8-ounce glasses of water daily.

• Healthy snacks and meals – Eat a balanced diet that is rich in fruits, vegetables, whole grains and fibers and low in saturated fat, trans fat and cholesterol. Make foods that are flavorful and simple to prepare. If your loved one needs assistance preparing healthy meals or snacks, consider hiring caregivers that for a few hours a week to help with advanced meal and snack preparation.

Mental Fitness:
• Deck of cards – Games keep the brain working and cognitive skills healthy. Play a game of Solitaire or flip the cards over and match numbers or suits to improve memory.

• Calculator – Maintain cognitive skills and financial health by keeping close track of monthly expenses.

• Newspaper – Reading exercises the mind and helps the ability to focus. Most newspapers also include a daily crossword puzzle, which helps delay memory impairment.

Overall Well-being:
• Calendar – Record doctor’s appointments, including preventative care visits. Also keep track of loved ones’ anniversaries and birthdays.

• Pillow – Getting seven to eight hours of sleep each night is important. Commit to a regular sleep schedule and develop a bedtime ritual, such as listening to soothing music or taking a bath.

• Telephone – Staying connected with friends and family is good for emotional well-being.

There is a higher probability of healthy aging success when there is support and encouragement from a senior’s loved ones. Families and friends can cheer on the seniors in their lives by giving them a “Healthy Aging” basket that includes some of the items listed above.

A simple matter of mutual respect

Customers in all lines of business can be difficult. When A&E aired the reality television show Airline it largely consisted of irate passengers berating Southwest Employees. One can't turn on an episode of Kitchen Nightmares without seeing some unhappy restaurant patron bemoaning the quality of their food. And how upset would you be if you drove a new car off the lot only to have it break-down a week later, installed a new washing machine that leaked water or bought season tickets to the Detroit Lions only to watch them become the first team in NFL history to lose all 16 games they played.

Of course, it isn't the Southwest Airline employee who your screaming at who's responsible for the bad weather or the planes mechanical error. It isn't the waiter's fault that the food isn't edible, or the car salesman's fault that the factory sent them a lemon or even the ticket takers fault that the Lions hired the worst General Manager in the history of professional sports. But sadly, they're the underpaid person who has to take the abuse and try to satiate you in some way.

In homecare, however, the anxiety of family members searching for assistance for their mother or father, grandfather or grandmother, spouse or child, is far greater than that of someone eating out or watching a football game. And unlike the research one might do before planning a trip or buying a car, when it comes time for mom to get some extra help, there's usually been no research conducted, there's virtually no "common" knowledge of what to do, and usually the time to make a decision is immediate.

So we understand when family members might lose their temper or wear their stress on their sleeve. We realize that much of homecare is "private pay" and the shock that crosses a family members face when they realize how much Medicare DOESN'T pay for can be off-putting to say the least. And we certainly realize that family members want the best possible caregiver for their mom (and want to pay as little for it as possible).

However, the truth of the matter is that caregivers are people too. They can also have "bad" days, feel stressed out about personal issues, or just not feel comfortable (or properly compensated) working a particular case.

It's important to remember that at the end of the day, the primary goal of both family member and agency is to provide the best possible service of the person receiving in-home care. There are reasons an agency such as Right at Home charges a certain rate and believe it or not, it's not solely to "maximize" profit. There are costs associated with liability insurance, worker's compensation insurance, bonding in addition to paying the caregiver a decent wage so that they are more likely to stay and not run to the next job that offers them 25 cents more an hour. In addition, one of the reasons a family signs on with an agency is because there is back-up in case the regular caregiver gets sick or has a family issue of their own and can't come in one day.

If you as the client are honest and respectful towards us as the agency, then in return we can work through difficulties together and ultimately have a far more harmonious - and far less stressful - relationship. And the real beneficiary of that strong relationship will the person receiving the care.