What keeps you awake at night? Technology? Regulations? Competition? Personnel issues? Why did Dave Roberts start Yu Darvish in game seven?
At the 2017 Annual Meeting of the National Association for Home Care and Hospice last month, Netsmart held a vote. Though informal, their ballot results deserve our attention because of the clever way Netsmart guaranteed widespread, unbiased participation. They filled six tall glass tubes with thousands of M&M's and labeled each tube with an issue of concern. Voters filled a bag with candy from the tube with the issue that most contributes to home care agency owner insomnia. Results were overwhelming: people.
The three emptiest tubes at the end of the last day were the ones marked Staffing, Training, and Compliance, with Staffing slightly ahead of the other two. More than technology, more than competition, more than any other threat to agency survival, owners and administrators worry about finding qualified staff, getting them up to speed on the latest regulations, and whether they will violate some rule that puts the entire agency in jeopardy.
Across the country, the raw math explains why these results were a foregone conclusion. 11,000 Baby Boomers celebrate their 65th birthday every day. The U.S. Department of Labor wins battle after battle in court to improve wages of in-home care providers, particularly non-medical caregivers. Year after year, MedPAC, Congress, and CMS collude to reimburse Medicare providers at lower and lower rates.
It is not that there are not enough workers willing to help our elderly and disabled with activities of daily living. It is not that there are not enough nurses in the country. It is just that fewer and fewer people are willing to work for the low wages agencies are able to pay. When the primary demographic of your workforce is a single parent with a 20 year-old vehicle, your primary concern is how many of them will miss a visit or shift every day due to a car breakdown, no money for gas, or a sick child at home. In fact, what Netsmart booth personnel heard most often last month is that a bigger problem than missed visits is people not showing up for the job interview.
New book offers 40 years of experience
Just in time, longtime home care consultant and best-selling author Tina Marrelli, RN has published one of the best reference manuals this reviewer has ever seen. "A Guide for Caregiving: What's Next? Planning for Safety, Quality, and Compassionate Care for Your Loved One and Yourself" should be purchased in bulk and distributed to every new hire at their first orientation class.
Ms. Marrelli is well-known for her manuals for administrators, Her previous books, Handbook of Home Health Standards and Home Care Nursing were aimed at medical professionals but this one is aimed directly at covering regulatory matters and clinical practices. This one is different. It is written to the medical and non-medical caregiver, in language that will not insult the former and not talk over the head of the latter. It is divided into topical chapters that allow the reader to pick and choose rather than feel obligated to read it straight through in order.
Part One is for all caregivers in general, including family members who are with the patient every day. In "The Caregiver Role: What the Caregiver Needs to Know," Marrelli discusses all the basics, in chapters such as:
Part One includes a glossary of common health care terms for the lay person and a comprehensive, 15-page directory or further resources, covering everything from healthy eating to pediatrics to veterans' issues to end of life care.
Part Two offers specific guidance for a dozen conditions. This is where the book becomes a valuable resource for every caregiver. You may win points with patients and their families, perhaps even with their referring physicians, if you gave a copy to every new patient with a family member as his or her primary caregiver. Ms. Marrelli provides detailed guidance to caregivers to prepare them for:
While Ms. Marrelli may not be able to ensure your potential employees show up for interviews, her latest effort does step in with a great deal of help after they do. Using this guide, the caregivers you do have will be better employees, better caregivers. As Dr. David L. Jackson, MD, PhD says in his foreword to Ms. Marrelli's book, 21st-Century healthcare presents many challenges. "[A Guide for Caregiving]...is loaded with practical 'nuggets' of information and is very well written. It will be a useful source of information and guidance for patients/families, nurses, physicians, and all other members of the team. Caregivers are an important part of the care team and this book will help them in their quest for quality care, whether in the hospital, at home, hospice, nursing home, assisted living, or other care settings."
©2017 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org