Respect Outweighs Wages for Home Health Worker Satisfaction

heath workers report higher levels of satisfaction with their jobs when they feel respected and valued by their superiors and the agency as a whole, while hourly wage doesn’t necessarily denote workplace satisfaction, according to a survey analysis published late last week.

The research aims to pinpoint factors that influence a home health worker’s job satisfaction and whether they affect his or her decision to resign. Its analysis was authored by Social & Scientific Systems, Inc. in conjunction with provider association LeadingAge.

Specifically, the analysis hones in on the extent to which compensation positively correlates with job satisfaction and negatively correlates with intent to leave; how job stressors or demands associate with job satisfaction and result in intent to leave; and the ways a supportive workplace leads to job satisfaction and lessens an employee’s intent to leave.

“It is critical to address workforce retention because these problems will probably be exacerbated in the future,” the report stated. “Understanding the determinants of turnover will help policymakers, agencies, workers, clients and their families to modify, to the extent possible, specific policy-level, workplace-level and worker-level factors that will support a more stable, quality home health workforce.”

Overall, the report indicates that home health workers who are dissatisfied with their jobs have greater intentions to leave. This held particularly true when considering agency structure and policy, as workers employed by for-profit chain-owned agencies are more than twice as likely to intend to leave their jobs as those working for non-profit or other organizations.

Analysis of the research finds that supervisors who show respect for home health workers and organizations that value their employees significantly impact overall job satisfaction. While this might seem obvious, some other findings are less intuitive: The report also suggests those with higher wages have lesser odds of being extremely satisfied with their work.

Another indicator of home health worker satisfaction is a work environment where employees are encouraged to discuss patient care with family, according to the report.

Jamie's Home Care Services

3049 Cleveland Ave Suite 276

Fort Myers, FL 33901

 802-526-4387

www.jamieshomecare.com

Written by Kourtney Liepelt

NAHC President Optimistic About Face-to-Face Ruling

The leader of the National Association for Home Care & Hospice (NAHC) is in a positive frame of mind following recent oral arguments in the organization’s lawsuitagainst the federal Medicare agency over the so-called “face-to-face” rule.

If NAHC succeeds in pressing its case, home health agencies may be paid a large portion of the $200 million to $250 million in claims that currently are in “limbo,” NAHC President Val J. Halamandaris tells Home Health Care News.

“I think the odds of our winning are very, very good indeed,” Halamandaris says, with the caveat that sometimes judges can issue surprising decisions. U.S. District Court Judge Christopher R. Cooper heard oral arguments in the case on Aug. 6.

Some of Halamandaris’ confidence is rooted in the success NAHC already has had—the association mounted a challenge that got the face-to-face rule’s “narrative requirement” struck down. This was a mandate that physicians not only had to see patients and certify that they were homebound, but provide detailed reasons why as well.

Imposing this requirement exceeded the Centers for Medicare & Medicaid Services’ (CMS) statutory authority, NAHC successfully argued. However, CMS only did away with the narrative requirement prospectively, meaning that a significant number of claims remained unpaid for the period between 2011 and 2014 when the requirement was in effect.

“There needs to be an adjudication of each of these claims on the merits, each one, and we feel confident that most will be paid, the great majority,” Halamandaris says. “That’s what we’re fighting for, the fair treatment on the part of people who went out and delivered that care. They shouldn’t be left in limbo … CMS has never said in absolute terms that the claims are being denied.”

Judge Cooper appeared to be sympathetic to the NAHC arguments, Halamandaris says. The judge had sharp questions for the CMS legal team, according to Halamandaris, and he does not believe the lawyers for the government were able to put together a persuasive case.

CMS does have one thing working in its favor, Halamandaris says: The fact that courts generally like to give agencies the benefit of the doubt when it comes to how they implement regulations. But in this case, it appears clear that CMS itself realizes that the narrative requirement was “inappropriate if not illegal,” the NAHC leader says.

While there is no precise timeline for a ruling, one should be forthcoming in the next few months, perhaps as early as September, Halamandaris says.

Jamie's Home Care Services

3049 Cleveland Ave Suite 276

Fort Myers, FL 33901

239-333-9517

www.jamieshomecare.com

Whats ok and whats not ok when you are a caregiver

What’s OK and What’s Not OK When You Are a Caregiver

By Cindy Laverty 

Everywhere I travel and meet caregivers, I see a common theme: Most family caregivers are afraid to ask for help. Somehow people think that they should just miraculously know how to care for an aging loved one.

Why would you know this? You did not receive PhD in Caregiving and your loved one poses challenges that you don't have the answers to. As I'm listening to their challenges, frustrations, fears, sorrows, stress-induced situations and overall feelings of being overwhelmed, I find that many caregivers seem to need permission from a professional to ask for help. So very simply, I reach out and take the person's hand, and give permission. Usually there is an instant look of relief in the person's face. It's incredible that giving someone permission to not be perfect helps relieve the pressure and the stress.

Caregivers frequently suffer from severelystressful emotions that can control and even ruin their lives. Sadly, these are the caregivers who, for whatever reason, have refused to ask for help or seek professional advice either from a medical doctor or a therapist. In order to manage the caregiving journey, you simply must step out of your comfort zone and find alternative methods for dealing with your personal situation.

The only way that family caregivers can sustain all that needs to be done to care for a loved one is to delegate responsibility and ask for help. It's really simple and it changes lives.

Here are some things that I think are okay for caregivers:

It's okay to be scared.It's okay to be angry, lost, sad and evendepressed.It's okay to lose your patience.It's okay that you don't want to sacrifice your whole life for someone else. And you shouldn't.It's okay that your self-esteem feels damaged.It's okay that you make mistakes.It's okay that you don't know how to do everything.It's okay that you don't have the answers.It's okay that you don't have a cure.It's okay that you're not there all the time.It's okay that you sometimes have extreme feelings towards the person for whom you are caring.It's okay that you lost your temper.It's okay that you had to apologize.It's okay that you're afraid.It's okay that you can't get everything done in a day.It's okay that you have guilt. All caregivers have guilt.It's okay that you have compassion fatigue.It's okay you feel trapped.It's okay that you took a few days for yourself.It's okay that you vented to your spouse or friend.

All of these things are absolutely okay. How you manage them is going to make the difference between becoming an Empowered Caregiver or staying in a hopeless situation.

Here are some things that are NOT okay.

It's not okay that you feel like you have to do everything yourself.It's not okay that you feel like an indentured servant.It's not okay that you are ignoring your personal needs.It's not okay that you are ignoring friends and social activities.It's not okay that asking for help paralyzes you.It's not okay that you don't have a plan in place.It's not okay to feel helpless and hopeless for days on end.It's not okay that you have stopped doing activities you once loved.It's not okay that you are afraid to say "no" or "not now."It's not okay that your siblings don't help you.It's not okay that you don't have boundaries in place.It's not okay that you feel unappreciated by your family.It's not okay that you have lost pride in what you are doing for another human being.It's not okay to sacrifice your financial security.It's not okay that you do everything your loved one wants, especially when the demands can be outrageous.It's not okay that you don't sleep or eat properly.It's not okay that you are constantly exhausted when help is available, if you would only seek it.It's not okay that you are sacrificing your personal health for another.It's not okay that you are constantly trying to fix everything that is wrong.It's not okay that you are living your life in crisis.

If any of the above rings true for you, then decide right now that you will get the help you need. Decide that you will live your life in a better way. Decide that you will take the necessary steps to ask for and get answers to the challenges that you are facing. Decide today that you are worth the time, energy and financial investment to survive, thrive and become an Empowered Caregiver

Jamie's Home Care Services

3049 Cleveland Ave Suite 276

Fort Myers, FL 33901

239-333-9517

www.jamieshomecare.com

Vascular Dementia

What is vascular dementia?

Vascular dementia (VaD), also called multi-infarct dementia, occurs when the cells in the brain are deprived of oxygen. A network of blood vessels called the vascular system supplies the brain with oxygen. If there is a blockage in the vascular system, or if it is diseased, blood is prevented from reaching the brain. As a result, cells in the brain die, leading to the symptoms of dementia. After Alzheimer's disease, VaD is the second leading form of dementia, accounting for up to 20% of all cases.

When Alzheimer's disease and VaD occur at the same time, the condition is called "mixed dementia".

How does vascular dementia affect the person?

Stroke and vascular dementia

Stroke is a common cause of VaD. A stroke occurs when blood flow in the brain is blocked or a blood vessel bleeds, preventing the blood from flowing properly through the vessel. When this happens, the brain cells cannot get oxygen and they die. Strokes can be large or small, and can have a cumulative effect, which means each stroke adds more to the problem. Strokes can affect how a person can walk, and cause weakness in an arm or leg, slurred speech or emotional outbursts. The difficulties the person has depend on the part of the brain that did not get the oxygen.

Vascular dementia usually comes on suddenly. Difficulties may happen in steps. Sometimes, the person’s abilities may deteriorate for a while and then stand still for a time. Then, they may deteriorate again. The cognitive symptoms, the ability to think, may change, affecting some areas of the brain more or less than others (e.g., the areas that control language, vision or memory). Urinary difficulties (difficulty going to the bathroom) are common in people who have VaD.

Binswanger's disease

Binswanger's disease is a rare form of VaD that is caused by damage to blood vessels deep in the brain's "white matter." High blood pressure plays an important role in Binswanger's disease.

How is vascular dementia assessed?

If VaD is suspected, the doctor will often order scans of the brain in order to check for blockages or narrowing of blood vessels in the brain.

What are the risk factors for vascular dementia?

Both men and women can be affected by vascular dementia. Risk factors include:

Being older than 65Having high blood pressure (hypertension)Having heart diseaseHaving diabetes

Smoking, being overweight, having high cholesterol levels and having a family history of heart problems may also increase the risk of having stroke, which increases the risk of vascular dementia. Mini-strokes (sometimes called transient ischemic attacks or TIAs) are warning signs that a stroke may come. Losing vision, speech or strength temporarily, or having short episodes of numbness may mean someone is having a TIA.

Routine brain scans in a group of middle-aged people showed that 10 per cent of them had had a stroke but did not know about it. Having the stroke, even if they did not know, raised their risk for more strokes and memory loss. These silent cerebral infarctions (SCIs, or silent strokes) are caused by a blood clot that blocks the blood flow to the brain. Many times, silent strokes are considered to make up a risk factor for vascular dementia. People with atrial fibrillation, the most common type of irregular heart beat in people over 65, have more than twice the normal rate of these silent strokes.

Knowing the risk factors for vascular dementia is important because often they may be treated, to reduce the risk of having a stroke. Risk factors can be reduced by adopting a healthy lifestyle that includes regular physical activity, eating well, avoiding smoking and reducing stress. Medications can control high blood pressure, diabetes and heart disease.

Is there treatment?

After a person has a stroke, medication may be prescribed to improve blood flow to the brain and reduce the risk of further stroke. A person may also benefit from different therapies to help with movement and speech, such as physiotherapy, occupational therapy or speech therapy. Aside from the treatment of the underlying causes of vascular dementia such as hypertension, high cholesterol and diabetes, some physicians routinely recommend the use of medications called cholinesterase inhibitors.

For more information:

Call your local Alzheimer Society or visit the We Can Help section of our website.Visit the Heart and Stroke Foundation website Mayo clinic Alzheimer's Society (UK); "Understanding Vascular Dementia"Webinar on vascular dementia presented by the Canadian Dementia Resource and Knowledge Exchange (CDRAKE)

[The contents of this document are provided for information purposes only, and do not represent advice, an endorsement or a recommendation, with respect to any product, serve or enterprise, and/or the claims and properties thereof, by the Alzheimer Society of Canada. The Information Sheet is not intended to replace clinical diagnosis by a health professional.]

Jamie's Home Care Service, LLC
3049 Cleveland Avenue Suite #276
Fort Myers Florida 33901
802-526-4397
239-333-9517
www.Jamieshomecare.com