Six years ago, Judy Loubier sat alone in the Tampa airport, praying for help with a seemingly unsurmountable problem: how to care for her retired and seriously ill parents in Florida while living and working in New Hampshire. Her mother, 79, had suffered a stroke, three weeks after part of her right lung had been removed on suspicion of cancer.
“In rehab she was one person in a lineup of wheelchairs waiting at the nurses’ station,” Loubier recalls.
Her father, 81, stayed at his wife’s side when he could, but had stopped eating, playing golf, and spending time with friends. Loubier and her sisters, who were commuting from New York and Boston, took turns managing their mother’s rehabilitation and caring for their father in his home, making meals, cleaning house, and keeping him moving forward despite his worsening depression.
The situation was heartbreaking. It was also unsustainable.
“I was completely torn, I needed to be in two places at once,” says Loubier, a physical therapist for 25 years who ran outpatient pediatric rehabilitation services at Elliot Hospital, and had a husband and high-school-age son at home. “I was praying, ‘God, how do we do this?’”
An airline magazine ad for a home care franchise pointed Loubier in a new direction.
This year, she celebrates six years running Seniors Helping Seniors in Bedford, a senior home care agency, a recently added division, LNA Plus, and the release of a book she co-authored with other caregivers: “Why We Care — Choosing the Right Home Care Agency.”
Available on Amazon.com
for $17.99, and the Seniors Helping Seniors website, www.shs-nh.com
, for $5.99, the 150-page paperback was published by the Institute for Dignity and Grace, a nonprofit that helps fund home care for seniors who have exhausted their financial resources. The institute was started by two other authors of the book, Nicole Perretti and Steve Weiss, a marketing expert and a former head of home care agency who coaches home care agencies.
The book is divided into sections for eight home care agency owners, and includes case summaries of families and caregivers finding solutions for various situations, including medically fragile seniors living alone; elderly couples battling Alzheimer’s or other forms of dementia; seniors returning from hospital stays unable to walk unassisted, feed or bathe themselves; and older, frail spouses struggling to care for even older and more compromised partners.
Loubier says the best way to use the book is to skim headings and read the summaries that resemble your loved one’s situation, and find direction and specific pointers.
“I’ve been through this journey now with a few hundred different families, and every case is different, but shared knowledge makes it easier. My hope is that people find I’m a resource, even if they’re never going to use our services.”
The New Hampshire Union Leader recently sat down with Loubier to talk about the book.Q: How do families find the right home care?
A. “Typically, when a senior is leaving a hospital or rehab center, the social worker will give you a list, or three business cards of home care agencies they have experience with and like to work with. Call and ask to speak to the owner, and/or make an appointment to meet and interview the owner in person. Ask for references from clients and family members.
In New Hampshire, all home health care agencies must be licensed and insured; ask to see a copy of those documents. Other important questions include: Do you have a minimum (hours of service), and what’s the cost? All the home care agencies in New Hampshire are close in price. Do you accept Medicaid or long-term care insurance? Everyone accepts private pay insurance. Most importantly: What services do you provide?
All home care agencies provide meal preparation, transportation, housekeeping, assistance with personal care such as bathing, dressing, and toileting, and medication reminders. But they may not be able to administer medication, for example, put eye drops in someone’s eye.
Do you provide 24-hour and overnight care? We’ve had situations where a whole family gets invited to a wedding out of state, and they’re scrambling to find 24-hour care with a new agency. Do you provide care through the end of life? Can you coordinate care with other providers, such as physical therapy and hospice? Can you oversee treatment and services like a case manager? Finally, what are your expectations when you hire a caregiver? The qualities they look for say a lot about their orientation and the quality of service they provide. Q. What do you look for in a caregiver? And what should families look for?
A. “I look for a good listener, and somebody who wants to establish a personal relationship. Many of the people I interview grew up next to their grandparents, or helped care for grandparents and miss them. The most important thing is the relationship, building trust, and having the senior they care for look forward to their visit.
It’s as much about playing Uno together and having tea and cookies as it is about making sure they eat and take their medications on time. You want your loved one to have quality of life, to enjoy the hobbies and activities they previously enjoyed as much as possible. That may not mean climbing Mount Washington or taking a vacation in Italy. Just holding someone’s hand provides quality of life. You have to be the person who’s always loving, who’s coming in positive.
In a caregiver, you want someone who sees the whole picture, what services are needed and which ones are not, who has experience to foresee difficulties that may come up. Often adult sons and daughters don’t know where there are gaps in home care. They’re just exhausted.”Q. What mistakes do families make?
A. “Waiting until the last minute. Ask the nurse or social worker about home care options early. There’s a shortage of caregivers in New Hampshire. I used to interview 11 a month; now I interview four. It’s important to be thorough and honest about seniors’ needs and limitations. Can they easily get to the one full bath in the house? Climb stairs to get into the house? If they’re at home, have you noticed any decline in memory or cognitive abilities?
Early treatment is key. Often the person who needs help is convinced they don’t need help. Be prepared to present the entire day of discharge, and carefully review the instructions. Medication needs to be picked up at the pharmacy; 30 percent of prescriptions for the elderly are never picked up. Have the home care agency come to the hospital or rehab center the day before discharge, and come to the house the day they get home.
And realize that caregiver relationships take time to develop. Allow three caregiver visits before you decide if someone isn’t a good fit.”Silver Linings is a continuing Union Leader/Sunday News report focusing on the issues of New Hampshire’s aging population and seeking out solutions. Union Leader reporter Roberta Baker would like to hear from readers about issues related to aging. She can be reached at firstname.lastname@example.org or (603) 206-1514. See more at www.unionleader.com/aging. This series is funded through a grant from the Endowment for Health.