Short essays by Douglas Winslow Cooper, Ph.D., the author of TING AND I: A Memoir of Love, Courage and Devotion, published in September 2011 by Outskirts Press (Parker, CO, USA), available from outskirtspress.com/tingandi, Barnes and Noble [bn.com], and Amazon [amazon.com], in paperback or ebook formats. Please visit us at tingandi.com for more information.
Friday, July 15, 2016
Home or Hospice – Making the Choice for Home Nursing Care
“In the United States, about 40 million people
provide unpaid care to an ill or disabled adult.”(AARP,
2015) Many of the readers of Sixty and Me are in this situation now or
might be in the future. Usually, the patient and caregiver would prefer this
care be given at home, if possible.
In June of
2004, my wife, Tina Su Cooper, and I were given a medical choice: home or
hospice. Tina had waged a 100-day battle against a near-fatal respiratory
infection due to her multiple sclerosis. She had entered the hospital near
death and paraplegic. She emerged near death and quadriplegic, on a ventilator
and fed and medicated through a gastric tube.
hospice care would mean that efforts would be limited to easing her transition
to death. Choosing skilled home nursing care would allow us to fight to keep
her alive. Our memoir, Ting and I, (http://tingandi.com) tells our story in much more detail.
we decided to continue the battle for Tina’s life at home. This involved setting up the equipment, hiring
personnel, and establishing procedures mirroring those of the hospital’s critical
care unit. We have succeeded at this for a dozen years.
this article I will discuss our earliest challenges in giving her the
round-the-clock care she needed in our home. Finding the right nurses is very
important for any caregiver who wants to provide the best care possible at
home. Staffing problems arose. We soon had to decide whether to continue with
the nursing agency we had or hire and manage the nurses ourselves.
a separate article I will talk about many tips for selecting a home care nurse.
Here I will focus on the two options you have for finding nursing staff: use an
agency or become “the agency” yourself.
Benefits of Using a Home Care Nursing Agency
you have done this before or are a medical professional, you will have little
idea of the complexity of providing skilled nursing care. Our head nurse (Diane R. Beggin, RN) and I have spent the past
year working on a book, How to Manage
Nursing Care at Home, due out in late 2016.
It is filled with material we learned from this experience; some of the
lessons having been hard-won.
you start with an agency, as we did,
you will get immediate staffing, and the agency will set up procedures for
assuring that proper feeding, treatments, medications, toileting, exercises,
etc., are instituted and recorded. They will assure that the nurse is certified
(as an RN, Registered Professional Nurse, or as an LPN, Licensed Professional
Nurse), and bonded or otherwise insured as trustworthy. You will pay
substantially more for the nurse than she will get, as the agency has its
overheads. One challenge is that these nurses take direction from their agency,
agency takes care of legal issues and will make sure that various governmental
regulations are met, including wage reporting and tax-paying. If the need for
nursing is “temporary,” using an agency will likely be preferable to hiring and
managing the staff yourself
Consider Becoming “the Agency”
agency we got started with was recommended by the hospital. It did a pretty
good job of finding suitable nurses and staffing our initial round-the-clock
needs. However, the quality of the nurses was inconsistent. We found that we
could pay the nurses about 50% more than they were getting and still charge our
insurer less than what the agency was charging.
What We Concluded
we found that managing the nursing care ourselves gave us a better selection of
nurses and greater control of what was being done, but it required our
developing procedures for managing the care and then implementing them.
favoring separating from the agency included my being retired, thus having time
to devote to care and management; the possible long-term nature of Tina’s need
for nursing, thus making the investment in setting up the procedures more
worthwhile; the availability of skilled nursing help obtainable through simple
advertising; the help of both legal and accounting experts to guide us. If
these conditions apply for you, then managing nursing care at your home may be
the better choice than relying on an agency.
Managing Nursing Care at Home
we became responsible for hiring and managing our staff, we had a whole new set
of challenges. We will discuss this in a follow-up article.
Have you or anyone you know ever
had to organize nursing care in the home? What were some of the challenges
A former Harvard
science professor, Dr. Cooper continues to publish, and he helps others
write and publish their books, via http://WriteYourBookWithMe.com. His life's dominant theme has been a
half-century romance with Tina Su Cooper, his wife, now quadriplegic due to
multiple sclerosis and receiving 24/7 nursing care at home, as discussed at
their website here.
I am pleased to have become a Featured Contributor at SixtyandMe.com ezine.