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Care at Home for People with disabilities 

Caring for someone diagnoses with disabilities such as cancer, diabetes, high blood pressure, Alzheimer’s Disease, dementia, stroke, heart disease, asthma or other pulmonary conditions can be challenging not only for the client but the entire family. A person use to being very independent may now find they need assistance with even some of the simple functions such as their ACTIVITIES OF DAILY LIVING (ADL’S) or  INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADL’S).

 

Post-discharge care can also be a powerful mechanism for preventing readmissions. Home Care Services such as Persoanl Care Assistance/ Certified Nurse's Aide are supervised by Registered Nurse. The Registered Nurse collaborates with your Physician(s) to ensure you have the care you need. The goal is work with the staff and report to the physician(s) to ensure you get the care you need and prevent unavoidable readmissions.

  1. Nursing assessments

  2. Catheter Care

  3. Pre & Post operative Care

  4. Inotropic Home IV Therapy

  5. Tracheostomy Care

  6. Wound care & dressings

  7. Wound Vac care

  8. Injections

  9. Intravenous therapy

  10. Tube feedings & care

  11. Ostomy care & teaching

  12. Diabetic care & teaching

  13. Disease process education

  14. Post Stroke care

  15. Hypertension, congestive heart failure (CHF) & Emphysema (COPD) care

  16. Medication Management

  17. Family Counseling & Teaching

  18. Identifying problematic side effects of medication which may need attention from your physician 

  19. Prevent hospitalization due to avoidable complications of the disease

  20. Monitoring and supervising the care of those members whose health status and situation involve complex observations

  21. Reviewing referrals from care coordinators,

  22. Evaluating the member's needs during initial and subsequent visits, and

  23. Identifying and assigning the appropriate staff to provide the member care needed

  24. Developing and revising member care plans as appropriate and reviewing the content of member care plans during each supervisory visit and communicating all revisions to appropriate staff

  25. Supervising personal support aides and licensed practical nurses
    completing clinical records, including documenting progress notes and supervisory visit entries

  26. Reviewing, signing, and dating all clinical record entries (i.e., service record forms, progress notes) made by the personal support aides assigned to
    those members whose health status and situations involve complex observation

  27. Communicating member care needs with other providers, member, member representatives, caregivers, and/or case management coordinators

  28. Making appropriate recommendations to care management managers or physician coordinators regarding member services

  29. Conducting face-to-face visits in the member's home

  30. Re-evaluate the needs of those members whose health status and situation involve complex observations arranging for orientation

  31. In-service training of staff educating the member, member's representative, and/or caregiver(s) about the member's health status, level of functioning, and health care needs

  32. Reporting changes in the member's status/condition to the member's physician

Skilled Nursing

Contact us today for a free Nursing Assessment.

Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.

Palliative care is provided by a specially-trained team of doctors, nurses, social workers and other specialists who work together with a patient’s doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment

Improves Quality of Life

Palliative care teams specialize in treating people suffering from the symptoms and stress of serious illnesses such as cancercongestive heart failure (CHF)chronic obstructive pulmonary disease (COPD)kidney diseaseAlzheimer’sParkinson’sAmyotrophic Lateral Sclerosis (ALS) and many more. Symptoms may include depression, pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping and much more.

But the team will also spend time communicating deeply with you. They will give you control over your care by truly exploring your goals and helping you to understand your treatment options. They will help you gain the strength to carry on with daily life and improve your quality of life.

A Partnership of Palliative Care Team, Patient and Family

Palliative care teams work together with your other doctors, you and your family. Close communication is key. The palliative care team spends as much time as necessary communicating with you, your family and your other doctors. They support you and your family every step of the way.

The core team includes doctor, nurse and social work palliative care specialists. Massage therapists, pharmacists, nutritionists, chaplains and others may also be part of the team

Palliative care
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