A Patient Advocate's View

Licensed Home Care vs Companion Care

I worked with Kathy Livingston, Senior Vice President of Senior Helpers in January 2010, on the newsletters for Senior Umbrella Network of Brooklyn . We spoke several times that spring about how she came to be the co-owner of a Home Care Companion Agency after working in the corporate world, helping franchise owners with their own home care agencies. Kathy invited me to participate in a lecture series at the Brooklyn Public Library, where she talked home care and I talked Patient Advocacy. Then, it was as if Kathy dropped off the face of the earth. She was going through the NYS Department of Health’s process for operating a Licensed Home Care Services Agency (LHCSA). The process took almost two years of full time work.

Last week I sat down with Kathy to ask her how operating a LHCSA has changed the services Senior Helpers offers. “We realized as a Companion Service that many of our clients required a higher level of care than we were able to provide. As a LHCSA, we have two nurses on staff so that we can provide services to people who have more complicated medical needs such as wound care.” Kathy explained, “Legally, we can treat many more people.

I have referred clients to Companion Agencies because they told me they just needed a little help. Sometimes I find that their needs really include medical services, such as actual help in the toilet, not just supervision to get to the bathroom. “People call our Agency and the first thing they want to know is what it is going to cost. That’s the wrong way to decide which type of Agency is right for you.” Kathy tells prospective clients, “The best way for me to help you is for me to understand your needs. As a LHCSA, we have a nurse who determines the level of care required and a Social Worker who coordinates the services for each client and matches them with the appropriate attendant.”

“There are four areas we review before deciding on a care plan, health, social, family and financial.” Kathy told me that resistance is the number one problem she encounters when children think care is required but the parent is not ready to accept the help. “We need to get to speak with the client. Others may think they know the kind of care their parent needs, but we are the experts. We are there to tell the client what they need. A client may insist on an attendant who drives, but that should really be on the bottom of the list of qualifications. LHCSA’s have strict training and quality rules that the Department of Health looks at before approving our license. We also seek Accreditation from the Joint Commissions, which is a periodic external evaluation by recognized experts that provides impartial evidence of the quality of care delivered to clients.”

Kathy recommends the book, Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved one Gets Older, by Mark Lachs,MD. “Our goal is to do the best job possible, and the LHCSA model allows us the opportunity to provide care for people over a long period of time, as they require more or less care.”

Kathy Livingston, Senior Vice President
Senior Helpers
353 West 48th St. New York, NY 10036

February 27, 2012 Posted by | Uncategorized | , , , , , , , | Leave a comment

Sometimes there isn’t any help.

The past few months have been busy with helping one of our favorite clients move. We set up a new blog for BeverlyTaylorJDL at worpress. Beverly just turned 86. We are going through everything she wants to have preserved and getting prices for things that will be sold to free up some space.

Peter is also moving, back to New Hampshire. He is recovering from knee surgery and can now live independently. We’ll be helping him pack up over the Labor Day holiday.

We’ve arranged for White Glove Consulting to help Arnold get the social services he needs, after a year of rejections and setbacks.

It’s great when you can help someone and accomplish what you set out to do. But sometimes, you just have to recognize that nothing more can be done. Issues related to mental health are something we’ve only dealt with in regards to seniors, dementia, Alzheimer’s, hoarding and personality changes. For the past few months, we’ve been helping a younger patient find health services. She came to us complaining of chronic fatigue and insomnia. As usual, we started with getting a medical clearance. Then, we arranged for a psycho-social exam for housing. We’ve gained an appreciation of the adult home business. They are truly dedicated people. The psychological assessment opened up a new diagnosis that changed our approach entirely. We were able to find many services that would have helped the patient. However, in our journey with her we found that she had a history of resistance to care and substance abuse. She was also under the influence of people who enabled her behavior.

After discussions with the psychiatrists, attorneys, the Department of Health, Abuse Victim Advocates and Mental Health Specialists we decided to end her services. This was a very difficult decision and one that included her family. They assured us that many had tried to help, but it was time to throw in the towel. The family will now move towards appointing a legal guardian. I’ve been told that we did help in many ways, just maybe not in the way we hoped.

August 23, 2011 Posted by | Uncategorized | , , , , | Leave a comment