Interactive Tools

Caregiver Stress Test

Caregiver Checklists

FAQs

Home Care Resources

Western Pennsylvania Resources

Home Safety Checklist

How Well Does Your Home Meet The Needs of Your Loved One?

Steps/Stairways/Walkways
Yes	No
		Are they in good shape?
		Do they have a smooth, safe surface?
		Are there handrails on both sides of the stairway?
		Are there light switches at the top and bottom of the stairs?
		Is there grasping space for both knuckles and fingers on railings?
		Are the stair treads deep enough for your whole foot?
		Would a ramp be feasible in any of these areas if it became necessary?

Floor Surfaces
Yes	No
		Is the surface safe?
		Nonslip?
		Any throw rugs or doormats that might slip underfoot?
		Is carpet loose or torn?
		Are there changes in floor levels?
		If so, are they obvious or well marked?
		Do you have to step over any electric, telephone or extension cords?

Driveway and Garage
Yes	No
		Is there always space to park?
		Is it convenient to the entrance?
		Does the garage door open automatically?

Windows & Doors
Yes	No
		Are windows and doors easy to open and close?
		Are locks sturdy and easy to operate?
		Do doorways accommodate a walker or wheelchair?
		Can you walk through the doorways easily?
		Is there space to maneuver while opening and closing doors?
		Does the front door have a view panel or peephole at the right height?

Appliances/Kitchen/Bath
Yes	No
		Is the room arranged safely and conveniently?
		Do the oven and fridge open easily?
		Are stove controls clearly marked and easy to use?
		Is the counter the right height and depth?
		Are cabinet doorknobs easy to use?
		Are faucets easy to use?
		Do you have a hand-held shower head?
		Are frequently used items on high shelves?
		Do you have a step stool with handles?
		Is it easy to get in and out of the tub or shower?
		Do you have a bath or shower seat?
		Are there grab bars where needed?
		Is the hot water heater regulated to prevent scalding or burning?

Lighting/Ventilation
Yes	No
		Are there enough lights, and are they bright enough?
		Do you have night lights where needed?
		Is area well ventilated?

Electrical Outlets/Switches/Alarms
Yes	No
		Can you turn switches easily on and off?
		Are outlets properly grounded to prevent a shock?
		Are extension cords in good shape?
		Do you have smoke detectors in all key areas?
		Do you have an alarm system?
		Is the telephone readily available for emergencies?
		Does the telephone have volume control?
		Can you hear the doorbell ring all throughout the house?

(Source: AARP)

Preventing Falls Checklist

Consider these safety improvements to minimize hazards that can cause a fall.

To Do All Rooms
		Install carpet with short, dense pile.
		Secure rugs with double-sided carpet tape.
		Use non-skid, no-wax flooring.
		Make thresholds even with floor.
		Arrange furniture so you can easily get around it.
		Reposition electrical and extension cords out of the way.
		Keep exits and hallways open.
		Use stable chairs with armrests to help you get up.
		Provide bright, evenly distributed light.
		Use lampshades that reduce glare.
		Put light switches and electrical outlets within easy reach.
		Use nightlights.
		Don't leave anything on the floor that might cause you to trip.

Stairs
		Install handrails on both sides of stairways at the best height for you.
		Make sure steps are even and in good shape.
		Check that carpet adheres firmly along stairs; repair or replace worn carpet.
		Choose a carpet that doesn't hide step edges or create illusions such as steps that appear deeper than they are.
		Remove rugs at the top or bottom of stairways and secure all other rugs firmly to the floor.
		Use good lighting (at least 60-watt bulbs) in stairways; install on-off switches at the top and bottom of stairs.
		Make sure stairs are clear of all objects.
		Watch out for a single step. People often trip when there is only one step.

Kitchen
		Choose sturdy step stools, preferably with handrails, and throw away broken step stools.
		Clean spills immediately to avoid slipping. Walk on floors only after cleaning solutions have dried thoroughly.
		Do away with floor wax.
		Don't stand on the countertops.

Bathroom
		Use rubber bathmats or strips in bathtubs and showers.
		Install at least two grab bars in the shower/bath.
		Clean up water from the floor.
		Secure bathroom rugs to the floor.
		Use raised toilet seats and install handrails within reach.
		Always use a night-light.

Outside
		Brightly light all paths and stoops.
		Install handrails along any flight of outdoor steps.
		Spread sand or salt on icy walkways.
		Keep steps, sidewalks, decks, and porches clear of newspapers, sticks, rocks, wet leaves, and other debris.
		Repair broken or uneven pavement on walkways and driveways.
		Remove roots that protrude from the ground.
		Clean spills immediately, especially oily ones on concrete or asphalt.

(Source: AARP)

How to Pay for Home Care

The cost of home care services can be paid either by the patient or through a variety of public and private sources including:

Medicare
Medigap
Medicaid
Older Americans Act (OAA)
Veterans Administration
Social Services Block Grant Programs
Long-term care insurance
Other private insurance policies

Outside assistance with paying for home care services is generally limited and usually covers only short-term needs. Eligibility for Medicare or Medicaid payment requires that the home care agency meets certain federal standards and provide skilled nursing services. Persons eligible for coverage under these programs must be homebound and under a doctor’s care.

Here’s what you need to know regarding cost:

Yes	No
		Is the agency certified to be paid by Medicare and Medicaid?
		Are there deposits, fees or any additional costs besides those charged for each service?
		Does the agency reduce fees for people who can't pay for all of their care themselves?
		When did the agency last increase its costs and by how much?
		How often does the agency bill for costs? Does it bill Medicare or the insurance company directly?
		Are all cost and payment expectations in writing?
		Is there a contract you can review before making a decision? Make sure you understand
		everything on the contract. Question any items that are unclear or contradict information you've been told.

Please note that coverage varies by state and policy, so it is best to consult with your home care provider or social worker for more information. Also, you should know that certain community-based, nonprofit home health care organizations, like VNA, can work with families to provide care to individuals regardless of their ability to pay for services.

How to Choose Hospice Care

Hospice is a philosophy of care which enables patients and families to make positive choices concerning physical, emotional, and spiritual care during life’s final stages. Choosing hospice care for your loved one can be a difficult decision during a stressful time. Following are some guidelines from VNA Hospice Services you may want to consider when choosing an agency that is right for you or your loved one.

Community Reputation

It is important to choose an agency with a long-standing reputation in the community. Ask trusted friends or family members about services they may have had in the past or consult your physician for recommendations. It is also important to know if the hospice care you will be receiving is based in your local area, or in another city or state. Hospice nurses are members of the community, your neighbors, and when you need assistance, it is important to have someone close by.

Services Provided

Hospices are regulated under Medicare guidelines, thus the required basic services provided by all hospices are the same. A team of specialists consisting of doctors, nurses, home health aides, clergy, counselors, social workers, therapists and volunteers are all available to assist patients and family members during this difficult time. It’s the specialty services that may make a difference and make choosing a hospice provider easier. Inquire about the credentials of the staff. It is beneficial to choose an agency with Clinical Nurse Specialists or nurses with advanced education in hospice care. Find out what the hospice does that is above and beyond what is required.

Medical Director

All hospices are required to have a medical director. When you are looking for a hospice, ask about the clinical experience of the medical director. Choose an agency with a medical director who has a background in or is certified in cancer care and/or palliative care.

Pharmacy

One of the main focuses of hospice care is to keep the patient comfortable and pain-free. Find out if the agency has a good working relationship and contracts with a reputable pharmacy to provide necessary medications for pain and symptom relief. There are pharmacists specially trained in end-of-life symptom and pain management who not only excel in that area, but will review all the medications a patient is taking to guard against interactions. It is also important that the pharmacist be readily available to answer questions.

Interview prospective hospices

Call and interview prospective hospices to see if they would be a good fit for you or your loved one. You should feel comfortable when talking with the agency representative, and they should be helpful and answer your questions to your understanding. Here are some questions you may want to ask:

How quickly can you see a patient once a referral is made?
Will you make an evaluation visit?
Will you involve the family and physician in planning care for the patient?
What is your on-call or after hours procedures? Does your staff work 24/7?
Is your staff readily accessible?
How much experience does your staff have or how long have they worked in hospice care?
Is there a physician on staff who will make house calls?
Are your nurses, aides, bereavement professionals and spiritual counselors certified through special training in hospice care?
What types of bereavement programs do you offer?
Do you offer any type of programs for caregivers?
Do you provide additional non-required services offering support to the community?
What is your philosophy regarding keeping people in their own home versus an institutional setting in the final days?

Deciding upon which hospice provides care to you or a loved one is your choice. Ask questions. The answers can make a big difference in the care and support you and your loved one receives. If you need any assistance with this process you can contact VNA Hospice Services at 877-862-6659.

Whether you have a question, need more information or guidance, call VNA’s Customer Center toll-free
at 1-877-862-6659.

Tools and Resources