IN THIS LESSON
How are they performing their ADLs (Activities of Daily Living)?
ADLs include:
Toileting *
Dressing
Bathing
Brushing teeth
Grooming
Eating meals
You’re using the same checklist from Lesson 1.
It’s also below in the Resources section on this page.
Activities of Daily Living (ADLs)
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Toileting
Can they get to the bathroom?
If using a walker, can they get in the bathroom with it?
Can they properly clean themselves?
Urinals are an option for men -
Dressing
Can they put on their shirts and pants?
Can they put on undergarments?
For women, will dresses suffice?
Is footwear nonskid and easy to put on? -
Bathing
Should someone always be present?
Baths or showers? Can they climb into a tub, then stand and get out?
Grab bars needed?
Shower bench/chair needed?
Nonskid bottom? -
Preparing Meals
Are they forgetful?
Will they remember that something is cooking?
How’s their hand dexterity for meal prep and cooking tasks?
Will Durable Medical Equipment (DME) help?
Will DME help to improve their quality of life and independence?
DME refers to supplies and devices for medical purposes. They are either prescribed by a healthcare provider or you would pay out-of-pocket. Prior noted dependent on insurance coverage.
If receiving home health, therapy may be able to advise/order appropriate DME (via physician prescription) to maintain safety in their home.
Click below to learn more about what falls into the DME category and for an idea of what is covered by Medicare.
Could a Home Health Agency help?
There are many options for home care services with different payors; all dependent on the type.
In the previous lesson I noted Home Health Agencies that provided Skilled Home Health Services where a therapist and/or nurse is involved (skilled). When it comes to assistance with ADLs, a skilled agency may provide services to assist with ADLs
IF there is also a skilled need for a nurse or therapist.
If not, there are agencies that provide services for ADLs only (non-skill, sometimes called custodial services).
For ADL only services, the payers (if they meet criteria) are usually
Medicaid,
Long Term Care (LTC) insurance
Veteran benefit or
you pay out-of-pocket.
More details for these payer sources are in Chapter 2.
If you are considering the home health route,
here is that Home Health Questions Checklist that was in the previous lesson.
What if you are not eligible for Medicaid, you don’t have LTC insurance or are not able to afford assistance for ADLs? I’ve found, this is one of the biggest dilemmas among caregivers.
What is one to do?
You educate yourself, get creative and get support
Keep going for the education piece.
Be open to creative solutions
and join the free Online Caregiver Support Group where you can get all three.
You’re in the right place
Important Consideration
*Safety alert again
If they require hands-on assistance, are not safe with transfers and toileting and their thinking is impaired (more about their thinking in the next lesson), an action plan is needed ASAP and they likely require 24/7 care. Reach out if you need guidance.
To Do
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Ability and safety?
Reminder: closely observe (more watching and assessing than advising) and allow them to proceed as usual. Make notes on the checklist.
Especially watch for the transfers and, if you can, their toileting.
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Make notes on your checklist of your observations and experience with your loved one
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Know the difference between Skill vs Non-skill. Here's that blog
Now You Know:
How your loved-one is managing their daily activities
Do these activities require someone being there? Especially for transfers and toileting
Home health and DME may be options
As you collect more information, you’ll start to develop and fine tune a plan. You’re building a knowledge base to tailor a plan for them & you.
So often we receive generic advice. Here you are taking the reigns to create & advocate for a plan that is tailored for them.
Kudos!
Let’s keep going… the next one is a tricky.