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  1. Somebody’s Sweetheart

    February 9, 2012 by admin

    The month of February and Valentine’s Day brings a celebration of love and stirs couples to rekindle feelings of romance and devotion. Not so different from young couples are aging seniors, celebrating memories of sweethearts and romance in days gone by. Sit a while with a senior couple and they will soon be telling you their romance story or listen to a widow or widower as they sing their favorite love song from their youth.
    Dementia and Alzheimer’s can rob senior minds of many of these treasured memories, changing their personality and life style. Because of these and other illnesses, many seniors end up in nursing homes or care facilities where only their basic physical needs are cared for by the facility staff. To these seniors, Valentine’s Day becomes no different from every other day. They often find it difficult to relive memories of the past. In one care facility a sign placed lovingly over a patient’s bed reads, “I Am Somebody’s Sweetheart,” as if to say I once dreamed, lived and loved, please treat me kindly.
    When asked how she relates to those she cares for, nurse assistant Karen W. replies that most of the time it’s those patients who are causing a disturbance or may be in danger of harming themselves who are the ones that get her attention. Even then she can only take care of the immediate problem. Very seldom has she time to personally get to know well all the elderly people she cares for.
    Although this is true with many facilities, the need for more personalized care is, in some cases, being recognized. Assisted living facilities with specialized memory care programs — some using art, music and dance or physical activities — are finding great success with increasing the quality of life for those suffering from dementia and Alzheimer’s. Many care facilities across the nation are adding these programs to better serve their residents.
    If you cannot find a facility in your area that provides this special attention, home care may be a better option.
    Consider this real experience. When Nora would visit her father in the nursing home she would find him sitting, slumped over and disinterested in his surroundings. By the time she and her young children finished their visit, he was alert and talking to them. Feeling he would do better in her home environment, Nora enlisted the services of a Geriatric Care Manager to evaluate her father and determine what would be needed for his care at home so that he could get the social stimulation that he needed.
    Home care personnel are skilled in working with the spouse and extended family members of their ailing loved one to provide needed services and support in the home. They add consistency in the care and are available in time of crisis or need to add additional services.
    “Somebody’s Sweetheart” may be in need of your loving care someday and help is available to reduce your burden and ease the journey.

  2. Veterans Benefits and Long Term Care

    February 7, 2012 by admin

    The Department of Veterans Affairs provides three types of long term care services for veterans.
    The first type is benefits from the VA healthcare system. This benefit is focused on those with service connected disabilities, who are receiving VA Pension or are considered low income. Services may include free medical care, free prescription drugs, orthotics and prosthetics, home renovation grants for disabilities, home care, assisted living and nursing home care. Availability of these services is dependent on the local medical centers funds, the nature of the disability and whether the veteran is considered low income.
    The second type of benefit is state veterans homes. The majority of these homes offer nursing care but some may offer assisted living care as well. Veteran’s homes are supported with a combination of state and federal funds. These homes are generally available to veterans and their spouses. There may be a waiting list in some states.
    The third type of benefit is disability income for active duty veterans. The first of these disability incomes is called compensation. It is designed to award a veteran a certain amount of money to compensate for potential loss of income in the private sector. In order to qualify for this benefit a veteran needs to have evidence of a service related disability. Some veterans may have record of being exposed to extreme cold, non-disabling injuries, tropical diseases or other incidents of exposure, while on active duty, which years later may be the cause of medical conditions. These veterans could apply to see if they could receive a benefit. Some veterans may be receiving Compensation but their condition has worsened and they can reapply for a larger amount based on a higher disability rating.
    The second disability income benefit is called pension. Pension is also called “Veterans Aid and Attendance Benefit”. It is available to all active duty veterans who served at least 90 days during a period of war. Applicants younger than age 60 must be totally disabled or a patient in a nursing home. Proof of disability is not required for applicants 65 years of age and older.
    The purpose of this benefit is to provide supplemental income to disabled or older veterans who have low income. If the veteran’s income exceeds the pension amount, then there is no award. However, income can be adjusted for unreimbursed medical expenses, and this allows veterans with incomes larger than the pension amount to qualify for a monthly benefit. There is also an asset test to qualify for Pension. The primary residence, most personal property and automobiles are exempt from this asset test.

  3. It’s All About YOUR Independence

    September 26, 2011 by admin

    Two-way personal emergency response (PERS) systems have been around for quite a number of years now. They continue to be an important tool to keep one aging safely in place. I am sure that you have seen the television commercials where a lady is lying on the floor yelling “Help me. I’ve fallen and I can’t get up.” Unfortunately this is an all too common occurrence. The longer a person lies on the floor without assistance the more difficult full recovery will be. One push of the button and you are in contact with trained responders. The commercial aired quite heavily on many television stations making it well known within the healthcare industry. It also created a sort of tunnel vision for seniors and providers alike.
    Just last week a client was telling me what she thought of our PERS system. She loves it and feels that it saved her life. This is the story I received form her. She was having difficulty breathing and was sitting on the edge of her bed. She decided to call her doctor. (I’m thinking, PUSH THE BUTTON). Her doctor was off so she spoke with the covering physician. He told her to wait 35 minutes and if she didn’t feel better dial 911. (In my head I’m screaming, PUSH THE #*!! BUTTON). My client decided that 35 minutes just did not seem right so, thankfully, she pushed the button. Oh yea, before she pushed the button she walked to the front door and unlocked it even though the responders have access to the key. She was in even more respiratory trouble by the time she reached her bedside. The responders arrived within minutes and transported her to the emergency room. She was admitted to the medical intensive care unit and treated for congestive heart failure.
    As you can see the PERS units are useful for more than just falls. Chronic illnesses can bring on acute symptoms that require immediate medical attention. They may be used in case of fire or police emergencies. They may be used for medication reminders and regular welfare checks. Monitoring companies are staffed with specially trained responders 24 hours a day, 365 days a year. So, if you have these concerns with yourself or a loved one call us for more information. Mention code WB-101 to receive the exclusive discount of $27.95 per month

    Dan Fisher RN, BSN
    A & D Home Health Solutions, Inc
    Visit our website:

  4. Top 20 Signs That Your Aging Parents Need Help

    August 26, 2011 by admin

    I am often called in to assist clients after they have gone into crisis mode. The crisis may be a result of medication mismanagement, a fall resulting in injury or driving to the barber shop down the street and ending up in another state. The ability to manage the daily household operations can deteriorate slowly over time. Family members may miss simple signs and symptoms of this inability to cope with the activities of daily living. The following list will help to identify the need for professional help for your aging relatives.
    1. Medication bottles that have not been refilled in the last two or three months.
    2. Medication bottles that are filled too frequently.
    3. Cluttered pathways.
    4. Increasing short term memory loss.
    5. Wearing the same clothes for weeks on end.
    6. Windows and blinds shut and locked tight at all times.
    7. Stoves cluttered and unusable.
    8. Washer and dryer cluttered and unusable.
    9. Decreasing personal hygiene.
    10. Unopened mail.
    11. Utility shut off notices.
    12. Empty cupboards.
    13. Empty refrigerator.
    14. Cancelled medical appointments.
    15. Cancelled hair appointments.
    16. Phone calls to friends and relatives in the middle of the night.
    17. Paranoia about friends and relatives stealing from them.
    18. Inoperable bathroom facilities.
    19. Thick blankets placed over the windows and blinds.
    20. Going out of the house without weather appropriate attire or wearing nothing at all.
    Having been a homecare nurse for the past 20 years I have seen all of these symptoms and many more. There are many options to assist individuals to remain as independent as possible in their own home. Knowing when to call in a professional care manager can be the difference between aging in place successfully and having to move to a skilled nursing facility.
    Dan Fisher RN, BSN, CEO
    Case Management Services

  5. Keeping Mom and Dad Safe at Home

    August 11, 2011 by admin

    Generally, elderly parents want to remain living in their own home. However, remaining in
    the home becomes a concern when children see their parents slowing down,
    perhaps even having trouble with handling stairs and doing general daily
    activities. Yet, with parents’ mental and physical health currently not
    creating problems, there seems to be no imminent need to search out support
    services or other accommodations for aging parents.

    This is now the time to evaluate the home to make it safe and secure for your loved
    ones — now and in the near future — in anticipation of aging disabilities
    that may occur. Help and support are available. The nation as a whole is more
    aware of elderly needs and services and products are becoming available at an
    outstanding pace.

    The Bureau of Labor Statistics states, “Employment of
    personal and home care aides is projected to grow by 51 percent between 2006
    and 2016, which is much faster than the average for all occupations. The
    expected growth is due, in large part, to the projected rise in the number of
    elderly people, an age group that often has mounting health problems and that
    needs some assistance with daily activities.” Bureau of labor
    Statistics-Occupational Outlook Handbook, 2008-09 Edition

    This growing need for aides and services also encompasses

    • home remodeling
      services — making a home more serviceable to the elderly;
    • safety alert
      systems and technology;
    • motion sensors
      to monitor movement;
    • telehealth
      services — using home-based computer systems for the doctors office or a
      nurse to monitor vital signs and
    • even a pill
      dispenser that notifies when it is time to take medication.

    Where do you begin to make sure your elderly family member is safe and managing well
    in his or her home?

    Visit often and at different times of the day and night. Make note of daily
    activities that appear challenging and where changes might be made to add
    safety and convenience. Remove rugs that slide — causing a fall — and move
    furniture with sharp edges. Set the water heater at a lower temperature. This
    will protect their older sensitive skin from scalds and burns. Be sure smoke
    detectors and carbon monoxide detectors are in place.

    Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a
    must to help prevent falls. There are easy to install bars at your local
    hardware store if you want to do the work yourself. Another item that is good
    to have is a shower stool or chair.

    If you are not sure of what needs to be done, consider hiring a professional.
    There are companies that specialize in home remodeling and accommodation for
    seniors. Michelle Graham of Accessible Design by Studio G4 says about
    senior home remodel projects,

    The main thing we incorporate in all of our projects is a
    careful study of needs and potential needs that may develop throughout a
    client’s lifespan.”

    Keep in mind what future home adjustments might be needed for
    your parents to “age in place” in their home.

    Home safety or medical alert companies provide GPS-based bracelets
    or pendants to track the elderly at home who tend to wander. Or the companies
    may provide alarm devices such as pendants or bracelets which allow the elderly
    to alert someone if there has been a fall or a sudden health-related attack. In
    the event an alarm has been triggered, a 24 hour monitoring service will alert
    the family or medical emergency services or call a neighbor depending on
    previous instructions. In addition there are companies that will install motion
    sensors in the home to monitor the elderly on a 24 hour basis.

    Don’t forget your parents’ community as a valuable resource for helping them stay in their home. Take Margaret Muller as an example. At 82 years of age, Margaret lives alone in her small home. She manages very well with the help of her local Senior Center. The Center’s “Senior Companion” program sees that Margaret is taken to the store for groceries and other needs and checks in with her often to see how she is doing. Once a day, the Senior Center delivers a hot healthy meal to her door. Having these services and visits gives Margaret the help she needs and peace of mind that she is not alone.

    Neighbors, local church groups, senior centers and city centers are some places to look
    for assistance. Most of the time there is little or no cost for these services.

    Your state aging services unit is a valuable community resource. The National Area
    on Aging website states:

    “AoA, through the Older Americans Act and other legislation, supports programs that help older adults maintain their
    independence and dignity in their homes and communities. In addition AoA
    provides funding for a range of supports to family caregivers.”

    Some of the programs the site lists are:

    “Supportive Services and Senior Centers

    Nutrition Services

    National Family Caregiver Support Program

    Grants for Native Americans

    Nursing Home Diversion Grants

    Aging & Disability Resource Centers

    Evidence-Based Disease Prevention

    Long-Term Care Planning

    Alzheimer’s Disease Grants

    Naturally Occurring Retirement Communities”

    A few thoughts on hiring home care aides or live-in care givers.

    The classifieds are filled with people looking for work as aides to the elderly.
    Many of these aides are well-qualified, honest people who will do a good job;
    but, of course, there will be some not so reputable. If you are looking to hire
    someone, be sure you interview and check references and qualifications. You
    will be responsible for scheduling that person and doing payroll and taxes as
    well. Be very sure you hire someone trustworthy, as the elderly seem to trust
    these helpers more than they should and therefore can easily be taken advantage

    A professional home care service will eliminate your employment concerns.
    Professionally-provided aides are usually bonded and service is guaranteed.
    Home care companies take care of the scheduling and payment of their employees.
    Home care companies cater to the elderly in their homes by offering a variety
    of services. Please take the time to visit our website for further information.
    A & D Home Health Solutions

    These providers represent a rapidly growing trend to allow people
    needing help with long term care to remain in their home or in the community
    instead of going to a care facility. The services offered may include:

    • companionship
    • grooming and dressing
    • recreational activities
    • incontinent care
    • handyman services
    • teeth brushing
    • medication reminders
    • bathing or showering
    • light housekeeping
    • meal preparation
    • respite for family caregivers
    • errands and shopping
    • reading email or letters
    • overseeing home deliveries
    • dealing with vendors
    • transportation services
    • changing linens
    • laundry and ironing
    • organizing closets
    • care of house plants
    • 24-hour emergency response
    • family counseling
    • phone call checks
    • and much more.

    Day, Director of the National Care Planning Council states,

    “Care in the home provided by a spouse or a child is the
    most common form of long-term care in this country. About 73% of all long term
    care is provided in the home environment typically by family caregivers.”

    As their caregiver, you can make the difference in the quality of
    life for your aging parents and if staying in their home is a possibility, you
    have the resources to make it happen.

    Dan Fisher RN, BSN

    A & D Home Health Solutions, Inc

  6. Steps You Can Take to Prevent and treat Urinary Tract Infections

    August 2, 2011 by admin

    Homecare nurses see a multitude of urinary tract infections every year. The occurrence of these infections is most notable within the first 7 to 10 days after discharge from a hospital or skilled nursing facility. While anyone can get a urinary tract infection some are more prone to them. Women get this infection more often than men. Senior women frequently have depressed immune systems which make them quite vulnerable.
    Symptoms of urinary tract infections include:
    • Increased frequency of going to the bathroom
    • Increased urgency to make it to the bathroom
    • Cloudy or blood tinged urine
    • A foul odor from the urine
    • Increasing confusion in seniors
    • Frequently a senior will display a subnormal temperature.
    • Nausea
    • Vomiting
    • Chills
    • Low grade temperature
    • Incontinence
    Seniors may not exhibit any signs or symptoms in the earlier stages of the infection. They may only have increased confusion, general feelings of discomfort and new incontinence.
    Prevention includes drinking plenty of fluids, cranberry juice and cranberry products appear to reduce the incidence of infections. When you feel the urge to urinate do not delay.
    Contact your physician immediately when one or more of these symptoms are displayed. Depending on the Take any medications prescribed by your physician exactly as directed. Even if you are feeling better and all signs and symptoms are absent continue taking the full course of medications.
    Dan Fisher RN, BSN
    Our Website

  7. 28 Points to Aging In Place Safely

    July 28, 2011 by admin

    Most adults want to remain in their own homes in their later years. However, accidents are a major cause of injury and death in the senior population. Successful aging in place is dependent upon certain safety measures taken within the senior’s home. It is important to remember that as an individual’s abilities decline the number of hazards in the home increase. Most accidents can be prevented with proper assessment and planning. The following list is a good place to begin:
    1. Clear all pathways of obstruction and ensure they are wide enough for easy access.
    2. Remove throw rugs and either replace or repair damaged carpeting.
    3. Phone cords and extension cords should never cross a pathway.
    4. Cords are in good repair and circuits are not overloaded.
    5. The thermostat of the water heater should be set at or below 110 degrees.
    6. All areas of the home are well lit.
    7. Handrails are secure and placed in correct locations.
    8. Stairs are sturdy and in good repair. Stairs have non slip strips or secured carpeting that is free of fraying or holes.
    9. Smoke detectors are located in hallways and near bedrooms.
    10. Bath tub or shower has a nonskid surface.
    11. A handheld shower head makes it easier to shower from while sitting.
    12. A raised toilet seat makes sitting and standing easier.
    13. Grab bars are installed by the tub and toilet. Grab bars are sturdy and secure.
    14. Chairs are sturdy and in good repair. Chairs with arms are a safer option than those without arms.
    15. Outside steps and walkways are in good repair. Hand rails are located in appropriate locations.
    16. Outside lighting is adequate around walkways and doorways.
    17. Inside stairways have switches at both top and bottom of the stairs.
    18. Emergency numbers are located by each phone.
    19. Medical history that includes contacts, medications, physicians and allergies is plainly identified and placed on the refrigerator door.
    20. Medications are kept in the bottles they came in. The senior can identify the name, purpose and frequency the drug is prescribed.
    21. A personal emergency response system is in place for instant access to assistance.
    22. Wheel chairs should be fitting with seat belts.
    23. If there are different levels within the home portable ramps may be installed by a professional.
    24. When stairs are a problem stair lifts may be installed by a professional.
    25. Check refrigerators and cupboards have a supply of food.
    26. The senior has a way to obtain groceries and medications, pay bills, banking and get to medical appointments.
    27. Outside walkways and driveway is cleared of snow and ice as soon as possible.
    28. Regular visits by family members or welfare checks conducted by an agency.
    These 28 points are a good start to ensuring that a person ages in place safely. There are other special considerations depending on functional abilities. These will be looked at in future articles.

    Dan Fisher RN, BSN, CEO
    A & D Home Health Solutions

  8. Understanding Long Term Care Planning

    July 27, 2011 by admin

    Mary is trying to prepare her son to avoid the mistakes she made with her husband Bill. Five years ago, Bill lost his ability to communicate due to Alzheimer’s. He also suffered from heart disease and diabetes. As his caregiver, Mary was never quite sure she was making the right choices about his long term care and medical treatment. Eventually Bill needed life support and Mary agonized over how Bill really would have wanted his life to end since they had never discussed it.

    Bill died last year. So many things were left undone regarding his care.

    Mary has decided to plan for long term care and medical treatment before it happens. She has designated her son as her personal care coordinator. She has given him written instructions regarding different care scenarios and how to prepare for care giving. He also has copies of her will and trusts as well as other legal care documents. She has provided him an extensive source of long term care information as well as a list of her personal financial resources. Mary has implemented the financial solutions to pay for her care. And finally, she has provided her son with a detailed list of government and private long term care service providers.

    By planning in advance for long term care, Mary has removed the guilt that loved ones feel in making care choices for her. She has researched and given direction on the types of care she desires, she has given direction and guidance to would-be caregivers and lastly she has planned for the means to pay for that care.

    An article on the AARP website titled, “Talking about Independent Living” states, “Research has shown that, as people age, they prefer to continue living independently, preferably in their own homes. While adult children often worry about their parent’s situation, it can be difficult to know if parents really need, or want, help from their children.”

    Children and parents should talk about all these things, except the parents should be the instigators and set the plan for the children to follow. What do you want your children, or friends to do in your behalf? When it comes time for them to help, you may not be physically or mentally able to execute your wishes. This is where your long term care plan comes into effect.

    The time to start planning is now. Don’t wait until the choice is no longer yours!

    Dan Fisher RN, BSN

  9. Recognizing the Need for outside Help in Caregiving

    July 21, 2011 by admin

    Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term the caregiver can handle it. Long-term, help is needed. Outside help at this point is needed.

    A typical pattern with an overloaded caregiver may unfold as follows:

    · 1 to 18 months–the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
    · 20 to 36 months–the caregiver is taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
    · 38 to 50 months–Besides needing tranquilizers or antidepressants, the caregiver’s physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

    It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled in a facility. Without intervention, the caregiver may become a candidate for long term care as well.

    It is also important to use outside professional help in a caregiver setting. A financial planner, care funding specialist or a reverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long-term care issues. The care manager has been there many times the family is experiencing it for the first time.

    An elder law attorney can help iron out legal problems. And an elder mediator can help solve disputes between family members. Having competent advice can often make the difference between allowing a loved one to remain in the home or being forced to seek out government welfare assistance.

    Due to pride or sheer determination some caregivers allow the situation to go beyond their control. They have gotten to a point where depression and fatigue have clouded their judgment. At some point the caregiver will have to admit that he or she can’t handle it alone and a better solution must be found.

    Dan Fisher RN, BSN

    Connecticut Care Planning Council
    A & D Home Health Solutions

  10. Why Work Through an Agency to Hire Private Duty Caregivers?

    July 18, 2011 by admin

    One of the greatest long-term needs of older adults and those with chronic illnesses is for in-home, custodial care services. These workers are often referred to as home health aides and certified nursing assistants. These in-home workers make it possible for people with functional limitations to remain at home in a comfortable, familiar environment. Home health aides (as we will refer to this class of workers) provide a wide range of assistance with activities of daily living (ADLs), such as bathing, dressing, grooming, assisting with ambulation or transferring, toileting, feeding and providing medication reminders. In addition, home health aides help with what professionals call, instrumental activities of daily living (IADLs), such as shopping, meal preparation, making medical appointments, transportation, laundry and companionship.
    Due to the cost and the increasing shortage of home health aides, many families seeking to hire in-home staff turn to private individuals rather than working through an agency. While at first glance this seems reasonable, it can also cause numerous problems and create unexpected liabilities for the family, who becomes the employer.

    Tax Issues
    As a private employer, the individual or family is required to pay Social Security, unemployment and payroll taxes. Many home health aides will represent themselves as independent contractors, ostensibly relieving the hiring individual of these tax obligations. However, it is the responsibility of the hiring individual to be sure that the aide truly is an independent contractor and is therefore paying their own taxes. In many instances, the aide will not meet the legal criteria as an independent contractor. If the aide has not met his or her tax obligations, this responsibility falls to the employer. This can be a serious obligation because it may involve interest on back taxes, civil fines and the possibility of criminal penalties. Potential private employers should seek the advice of a labor lawyer to assure appropriate hiring practices with respect to federal tax laws.
    Workers’ Compensation and Liability Issues
    As the employer, the individual or family paying for the private home health aide would be held liable for any work-related injury that occurs on the job. This can include the cost of all medical expenses and any disability payments that might become applicable.

    Since the home-care industry is noted for work-related injuries, this can be a huge risk, especially if the caregiving tasks include lifting, transferring or bathing. There are also risks related to communicable diseases if the aide does not abide by universal precautions that are required by all licensed agency personnel.
    Furthermore, the employer retains any liability that arises out of an injury to the person being cared for or any other person on the premises. If the home health aide were to cause an accident, for example, in which other family members suffered any harm or losses, the employer would bear the full responsibility for all costs and compensation.
    Abuse and Exploitation
    Unfortunately, there is the potential for both physical abuse and financial exploitation when work is being done on behalf of a frail, functionally limited, and often cognitively impaired individual. While most individuals who become home health aides do so out of a desire to help others and to contribute to the community, there will always be those who see this type of work as an opportunity to take advantage of someone. This becomes especially easy when the aide and the recipient of care are isolated in a private home setting with little or no supervision.
    Families don’t fail to provide supervision out of malicious neglect. Supervision is often difficult because of geographic distance, lack of expertise, or the close emotional bonds that often get established between the aide and the person receiving the care. Furthermore, families often do not have the time or the resources to do criminal background checks, or to contact references, if they even think to ask for references. Sometimes families are so grateful for the care provided by an aide that they are also vulnerable to manipulation and exploitation.
    Agency Supervision
    A licensed home care agency has a responsibility to provide ongoing supervision for their employees. This includes helping the aides to understand the changing needs of clients, assuring the proper limits of care according to the practice acts of the various levels of professionals, and mediating difficult relationship issues.
    Providing supervision is often as important for the aide as it is for the family. Home health aides often work with very challenging situations in the isolation of the private home situation. There are often issues of different cultural and faith traditions, different expectations about personal schedules, eating preferences and expectations. An agency supervisor can help to clarify the roles of the home health aide, and the expectations of both worker and care recipient. Furthermore, the agency can support the aide in setting appropriate limits on the types of care that can be provided. For example, an older adult might expect an aide to help with dressing changes or high tech care that is legally the responsibility of a licensed nurse.

    In situations in which there are personality issues because of cognitive changes or a history of challenging relationships, the agency supervisor is available to provide guidance and support to both staff and care recipient. This can be very fragile, especially if there is a lack of trust or behaviors that are strange to the home health aide. The support of a supervisor can help the aide understand that this is part of the disease process and cope with behaviors so that the aide and the client can have a successful relationship. Often, supportive supervision is the key to making a challenging situation work.

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