The Many Benefits of Keeping Your Aging Parents at Home

The Many Benefits of Keeping Your Aging Parents at Home


In the article The Benefits of Aging in Place, this note jumped out at me: Read more


Keeping Your Parent at Home

Keeping Your Parent at Home


Conventional wisdom is that seniors want to stay in their home but this is often not feasible due to the cost involved with providing in home care.

Most articles compare the costs of in home health care vs. assisted living or nursing homes. These articles are filled with gloom and doom detailing how caring for your aging parents, at home or in a care center, spelled financial ruin.

At Physician’s Choice Private Duty, we look at things a different way.  We know that it is possible to keep parents in the home without breaking the bank, if that’s your goal.

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Nursing Life Hacks

Here’s a favorite article from http://nurseslabs.com that we love and you’ll find helpful!

Nursing is a tough job and apparently, there are no shortcuts to providing good and quality care. However, this doesn’t mean we can’t make our lives easier while doing our job. Here’s list of nursing life hacks that can show you exactly how.

(we’ll give you the first 6 and if you’re interested, the full list of 30 will appear here: http://nurseslabs.com/30-nursing-life-hacks-probably-didnt-know/)

Go slow when you prime your IV. When you go full blast with the flow, there’s a good chance for tiny air bubbles to form within the tube. To avoid this, you can clamp the tube first, fill the drip chamber and let the fluid flow slowly. See also: 50 IV Therapy Tips and Tricks

Use gauze to prevent hair pulling when using a tourniquet. The friction a tourniquet creates against hair can be painful to patients. To address this, try placing a thin sheet of gauze in between the tourniquet and your patient’s skin.

Prevent pinching. Fold a washcloth and tuck it under the front of the bedside commode seat to prevent pinching.

Use hydrogen peroxide for blood stains. While we technically have no problem seeing blood, having them on our white uniform or your favorite scrub suit is a different story. Instead of wearing blood stains as your battle mark the entire shift, you can apply a few drops of hydrogen peroxide as a stain remover.

Removing blood stains with hydrogen peroxide
You can remove them from patient pillows too. Image via: Pinterest

Didn’t hit the mark? Try double insertion of foley catheters. Missing the mark isn’t only common to new nurses. The truth is, whether you’re a veteran or not, we’ve all had our fair share of the experience. When inserting a foley cath to a female patient and you fail to get a return, leave the first catheter in place and try the same procedure with another Foley catheter, aiming higher this time.

Powder a bedpan. Powder a bedpan before you put a patient on it for easier evacuation; especially useful for obese patients.

Those are the first 6 hints. Pretty great, right? If you’re interested, the full list of 30 appears here: http://nurseslabs.com/30-nursing-life-hacks-probably-didnt-know/

When Less Medicine Means More Health

Less is More

By John Henning Schumann, MD from NPR

Six months ago, an octogenarian patient told me he’d been having light-headedness. For decades, he’d taken a combination pill (two medications in one) to keep his blood pressure below 140/90, numbers proved important in preventing heart attacks, strokes, and kidney failure. Light-headedness is common among older people on blood pressure drugs. “It’s as though I’m going to pass out,” he told me. “My vision fades, and I get wobbly legs.” Fortunately, my patient’s episodes had passed without him actually falling.

He and I agreed that it would make sense to stop his medicine for a month and see what happened – something called a drug holiday. My patient agrees to buy a home blood pressure cuff, use it two or three times a week, and share the results with me. A month went by. His blood pressure, over multiple readings, was fine. And no more light-headedness.

I wrote him back: “Stay off the medication – it’s clear from your readings you no longer need it.” He was thrilled. The decision saved him money and meant he could forget about one of his many daily pills.

Now new research has thrown that decision on to question. A federally funded study was recently stopped early because of evidence that aggressively lowering blood pressure saves lives. The new findings indicate indicate that getting the top (systolic) number to 120 or lower is even better at saving lives than the current standard of 140.

Still, I am satisfied my decision was a good one. I helped my patient avoid a drug-related problem like a fall and maybe a hip fracture – one of the banes of our aging population. What’s more, he and I pushed back against medical inertia the tendency to keep things the way they are because it’s easier than making a change.

My patient’s experience and stories like his have led me to believe that there comes a point in aging when our physiology changes. No doubt there are many factors, such as our senior brains, stiffening blood vessels, and changes in the ratios of our hormones. Sometimes age brings more illness, but in other cases, problems seem to diminish.

Too often, we overlook the option of de-prescribing, or discontinuing medications in older people who take a lot of them. A recent review of more than two dozen studies in which patients discontinued medications (including sedatives like Valium as well as blood pressure drugs) found that people did surprisingly well when they stopped taking them. Adverse symptoms abated, and their health generally improved.

As a doctor looking first to do no harm, I draw the following conclusion: Though I am ready to believe the better low blood pressure outcomes promised by the latest research, I’m also going to look for opportunities to minimize the overuse of drugs in older patients. For many of us, less medicine means more health.

If you have questions or concerns about your medications, contact us today. 402-991-7399

Armbrust Family Testimonial

Armbrust Family Testimonial

Armbrust Family Testimonial

Dear  Staff,

We would like to thank all of you for the loving care shown toward Willis.

Your assistance, thoughtfulness and kindness helped us through this difficult time.

God Bless,

Amy and Armbrust Family

John and Anne Hall Testimonial

John and Anne Hall Testimonial


John and I are so grateful for the extended time and effort you have provided over the past few months. Your insights and strategies were invaluable. This is a journey and your guidance has made it less stressful and manageable. We particularly appreciated your focus on Kay – as a person, not just as a “patient”.

Thank you for doing so much and for doing it so well,

With gratitude,

John and Anne Hall

Wendy Testimonial

Wendy Testimonial

Wendy Testimonial

Dear Encompass “Angels”,

Thank you so much for your efficient and timely help this year!

Blessings Wendi

Monroe Testimonial

Monroe Testimonial

Monroe Testimonial

Please accept my family’s sincere thanks for the care assistance that you and your Encompass Colleagues provided during our Dad’s home hospice care. You, Delra, Brenda, Barbara and Connie, were of immeasurable help to Dad, Melissa and me during a very difficult time.

We appreciated the excelled way that you coordinated with Hospice of Southwest Iowa to make things go as smoothly as possible.

Thank you again for your very caring assistance during a time of great need.


The Family of Norman Monroe

Questions to Ask A Home Health Care Agency Before Hiring Them

Questions To Ask A Home Health Care Agency Before Hiring Them:

Have you ever had the experience of buying a product or service only to realize later that there were questions you wish you knew to ask up front? One of the advantages I have is that I’ve been through this process multiple times over the years and I’ve put together a list of questions you can use to have a shot at eliminating “buyers remorse.”

Who do you send for the initial in-home assessment?

Is it a skilled nurse? Is there a social worker?

Is this a free service? Will you be trying to sell me your services or simply recommending what I need?

How do you make sure your caregivers are nice, trustworthy and that I’ll be safe?

Do you screen your caregivers?

Does your agency conduct statewide police checks?

Is your agency bonded?

How much experience does your average caregiver have?

Does your agency hire experienced caregivers?

What sorts of tests do your employees have to take?

Do you have health and skills testing?

Did they mention Caregiver Code of Conduct™?

What happens if your caregiver doesn’t show up to my home?

Do you have a system for handling caregivers who don’t show up?

Who supervises your caregivers and how do you know they are doing their job?

Are the caregivers supervised?

How do you keep the family informed about what goes on during the day?

Does your agency have a policy for keeping the lines of communication open?

How do your hours and overtime work?

Will your agency accommodate the hours I need?

Does your agency take responsibility for overtime hours that I did not schedule?

What type of services do you provide?

What if I need skilled nursing or therapy?

When are your caregivers available?

Do you have around the clock availability?

Who handles unemployment, Workers Comp and other taxes?

Are you the employer?

All the above questions are very important to have answered before moving forward with a home health care agency.

Feel free to contact me and learn some of the stories behind these questions. My office number is 402-991-7399.

The 12 Most Important Evaluation Points When Considering a Home Care Agency

Because good decisions result from good information, this guide was created to help you evaluate home care agencies and make the best choice the first time. Please take 10 minutes to review the important elements that make up a good home care agency.


It is important that your initial in-home assessment is provided by a registered nurse and social worker – this
insures your medical issues, personal needs and desires are communicated by a professional.


When you hire a professional home care agency, you expect to receive quality care provided by a compassionate, empathetic and caring person. The real question; how do you make sure this will occur? Encompass Senior Solutions screens caregivers for experience, skill and personality. To ensure caregivers are reliable and honest, extensive background checks, including statewide police checks, are performed on all new hires and we are insured and bonded. ESS also mandates drug screening upon hire and whenever there is a potential issue.


The very best agencies hire only experienced caregivers. To make sure your needs are met, Encompass Senior Solutions recruits caregivers who have experience and are seasoned in attending to the needs of care recipients.


A good home care agency will test employees to assure their personal health, skills and capability. Standard testing for all Encompass Senior Solutions employees includes competency testing, TB tests, pre-employment skills testing, and random drug testing.


Insist on an agency that incorporates training that focuses on core values such as attitude, character and respect. Caregiver Code of Conduct™ is a training and certification program developed to enhance caregivers’ skills in areas of social and client interaction. Encompass Senior Solutions is proud to offer this training to their staff.


One of the most common problems that people have with the average home care agency is that the caregivers don’t show up. Choose an agency that has a system to handle the caregivers who cannot fill their shift. We pay bonuses for perfect guarantee all shifts. The state average is 78% of shifts being filled. Encompass Senior Solutions staffs at 100%.


A good home care agency will provide field nurse supervisors who perform unscheduled supervision visits to help make sure that you are receiving the best care possible. The field nurse supervisor visit is also a good time to communicate any concerns you may find uncomfortable discussing with your caregiver. (If you prefer not to receive unscheduled supervision visits, be sure to tell the agency.)


For peace of mind you need an agency that has a process to keep you informed. Encompass Senior Solutions’ caregivers keep careful notes of each visit in your home to provide a quick snapshot of their activities and are always available for review. Our staff is also trained to alert family members regarding any changes or concerns regarding the client, in addition to responding to clients’ or family members’ concerns.


Make sure the agency you hire will modify the schedule of your service — without financial penalty. Also ask about their overtime policy. Some agencies charge you time-and-a-half for any aide that is scheduled over 40 hours. Unless you specifically request additional hours from a caregiver that is already scheduled 40 hours for that week, the agency should be responsible for any overtime pay.


Everyone’s needs are different. Choose a homecare agency that can provide services for all your personal and unique needs. Encompass Senior Solutions provides all levels of service from errands, shopping, light housekeeping to hygiene assistance, medication reminders, skilled nursing services, therapy and more.


The time of day you need assistance can vary from the middle of the night to very early in the morning, so make sure the agency can accommodate you any hour you need them. Encompass Senior Solutions is available, mornings, nights, weekends, holidays, temporary or long term.


There are two types of home care companies; one is a registry that finds a person for you to hire. In this situation you are the employer and responsible for Workman’s Compensation, unemployment and other State and Federal taxes. To avoid being responsible for taxes, and the risk of a hefty Workers Compensation claim, only hire an agency (as is Encompass Senior Solutions) who provides you with caregivers that are employees of the agency, and not working independently.