Narrator: Mary Di Sario, an elder nurse consultant describes her role and tips on how to select the right type of home care resource.
Mary: As a nurse consultant, I sit down and meet with families and try to help them analyze their situation and identify their needs. Among this is to identify the needs of the individual, and the goal is always to try to keep the individual at home - that is first and primary - and this is really the wish of most people, and most families is to try to keep their loved one at home as far as long, as it is physically and safely possible. So I'm always working towards trying to achieve that goal, and in that process, we have to explore many pieces of a puzzle as I explain to the families because let's face it, the factors that will determine your options in life. Among that is your financial situation - the support network that's available, the physical environment, the home that this person lives in - Is it a safe home? Is this a doable thing? And this person remains safely in this home or maybe they can live, in fact, remain safely. But perhaps some minor adjustments need to be made to meet their growing needs and to keep them safe and functioning at the home. So when I work with the families, we identify all these things, we - financial legal issues, caregiving issues. environmental issues, how that person functions, and how much assistance they need to get through the day safely and remain at home. So based on all the information we've gathered and analysis of all the factors, then we're able to make recommendations on a plan of care and actually recommend resources such as a geriatric care manager or companion agency or whatever would be appropriate to fill that person's needs.
Mary: Companion level is the very basic level of care and these folks really have minimal training in the sense of medical training, but they are quite capable to provide companionship to provide assistance in the home as far as providing a light meal or snack and super general supervision; or they can accompany a person, to do errors or to do errands, or to a doctor or that type of thing - but that would be the very basic companion level. Then we have a personal care assistant to PCA, and these folks have received some minimal training and are able to provide some hands-on care. They are able to assist a person with their physical needs as far as if they needed to be assisted into the shower or to maintain personal hygiene. They have a little bit more training and they're accustomed to doing that. Then we have home health aid, and again, it's just another step above the PCA where they are a little bit more experience. They can help with say with exercise programs and they can, in addition to the physical hands-on care. They have a little bit more knowledge, perhaps a bad diet and providing this is the proper diet for the person if they're diabetic or that type of thing. So, and then the highest level is CNA certified nurses assistant which is someone that you can aid that you would find more in a lesson in the hospital setting or a nursing home setting. These are the folks who have received an additional training and are at the higher level. They are not usually found in home care. They're pretty much - their expertise is found and needed in the institutional setting, although there are many times that home health aids have multiple certifications. They may be a PCA and an HHA as well, and HHA, maybe a CNA, and they work interchangeably to some degree.