The most important thing to Nina is to keep living at home.
“I will do anything I can to not go back to the hospital,” said Nina, an older woman who lives in western Massachusetts. “I tell you, there’s nothing worse than being in the hospital.”
When she went into the hospital after a fall a few years ago, doctors discovered she has congestive heart failure (CHF) and problems with her kidneys. The doctors also say she had a heart attack at one point. After her hospital discharge, Nina went to a rehab hospital where she contracted pneumonia. She was finally able to go home with the help of24-hour elderly care provided by Homewatch CareGivers. Her caregivers no longer stay overnight, but they still come every day as Nina is now generally confined to a wheelchair, making her very dependent on her caregivers. They help with meals, do light housekeeping and make sure she’s in bed for the night before they leave. Mostly, they help her stay out of the hospital and remain at home where she wants to be.
Nina called Homewatch CareGivers when she was ready to be discharged because she got 24-hour care for her husband when he fell ill a few years ago. Through the help of her long-term care insurance, she is able to get the same sort of senior care for herself.
“If I did anything good for my husband before he died, it was to keep him at home. He died at home and the girls [from Homewatch CareGivers] were so good to him. It was fabulous and they are the same with me. There’s just nothing like good home care,” she said.
When Nina got out of the hospital, her doctor wanted her to consider an assisted living facility, but he agreed that she wouldn’t get the attention there that she does now through Homewatch CareGivers.
“I wouldn’t be able to stay at home without them. I absolutely wouldn’t,” she said.
Nina’s caregivers help make sure she does not fall victim to any of the four main reasons that cause hospital readmissions. Hospitals are also now paying more attention to readmissions after the Medicare penalties began on Oct. 1.
According to many health experts, including Eric Coleman, MD, MPH, a professor of medicine at the University of Colorado, the main reason people end up back to the hospital is due to medication mismanagement. Homewatch CareGivers makes sure Nina takes her pills at the time they need to be taken and her caregivers even supply applesauce to get the job done.
“Then you swallow that down and you don’t even know you’re taking them. They are big enough for a horse,” she said.
Coleman and other health experts say the second reason people end up back in the hospital is because they do not go to follow-up appointments with a doctor or medical professional. Nina’s caregivers take her to those appointments, which include trips to a hospital every two weeks for blood work.
“They take me to the bank, the grocery store, and doctors’ appointments. Some weeks we go twice a week, sometimes we go three times a week,” she said. “If I want to go for a ride, they take me for a ride.”
The third major cause for hospital readmissions is a fall. Nina is no stranger to falling – she fell twice in one year.
“Both times I was trying to answer the door and I was trying to get there in a hurry and I fell while doing so,” she said. “After the last fall, I said that’s the last time I’m going to hurry to get the door.”
Her caregivers now answer the door for her.
The fourth most common reason people end up back in the hospital is if they don’t follow a doctor’s recommendation for diet and exercise. Nina can cook from her wheelchair, but it makes her nervous since she is only level with the stove. That is why her caregivers do most of the cooking.
“Whatever I want, they do it,” she said. “We do try to stay within the healthy guidelines.”
That includes a low sodium diet, even though Nina isn’t a fan of it.
“They have to be able to cook to work with Nina,” Judy Yaffe said. “She likes a good cook.”
Judy and her husband Peter own the Homewatch CareGivers office in West Springfield, Mass. that takes care of Nina.
“Any new caregiver that comes on board has to shadow the current caregivers before they can work with Nina,” Judy said. “They have to be trained caregivers. I’m not sending in somebody fresh out of school. They have to be mature and have to have experience in personal care.”
Judy says many of the current caregivers worked with Nina’s husband when he was still alive.
“They’re just really, really good to me,” Nina said. “They do anything they can to make the things the way I like them. They’re just wonderful. It’s like I have a friend with me to keep me company.”
Her family also appreciates the trained caregivers.
“They’re very glad that I have somebody close enough to do what one of them would do if they lived closer. I guess they wouldn’t have to, but with trained caregivers, they don’t have to feel guilty,” Nina said.