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What's In a Plan of Care?

Your Amdal In-Home Care plan of care is a written document developed by your Care Coordinator and you.  It is posted in the home, and serves as a guide to the specific care services our Personal Care Attendants are to provide while on duty.  This document is reviewed often, and revised as necessary.   The first areas we address in a care plan have been distilled into an acronym - NOAH ™  - which stands for:

 

Every Amdal In-Home Care Personal Care Attendant is trained to pay special attention to these four crucial aspects of a client’s condition. 

If these basic needs are adequately addressed, we often see an improvement in quality of life or, at the very least, a stabilization.   

Though there is much more that goes into a plan of care this should give you an idea of our approach to care, and how we assess a client’s needs. Below are some of the areas we address in each plan of care, and why:

 

Nutrition

The body needs good fuel to function and as you age it is even more important.  Muscle mass starts to diminish.  The majority of the elderly see cooking as a chore so nutrition declines over a period of time.  Taste buds start to die and food doesn't taste as good.  Amdal In-Home Care has developed a wide range of senior-friendly diets and menus that can address such needs as low-sodium, low fat, renal-friendly, soft foods, and diabetic.  Our Care Coordinators can perform a nutritional assessment to determine the best diet.  Our staff can shop and prepare meals if necessary.

Oral Care

A clean mouth facilitates pleasant eating.  A dirty mouth will affect the taste of food.  The mouth is in essence an opening to the lungs.  Bacteria in the mouth can migrate to the lungs which can lead to various infections.  Poor oral hygiene has been linked to heart disease.

Ambulation

Our bodies were designed to move.  As one ages, movement becomes decreased.  Everyone should be encouraged to move to the best of their ability.  Even if that means a bed bound person sits-up a few times a day.  The less you move the harder it becomes, and over time people become resistant to moving.  It is a vicious cycle.  Amdal In-Home Care pays attention to a client’s ability to move and exercise, and encourages it regularly.

Hydration

All of our bodies cells need fluid.  Muscle is composed of a great deal of water.  As we age our need to drink fluid diminishes.  Many medications cause dehydration.  Sips of cool water need to be provided throughout the day unless a health issue such as kidney failure prevents that.  Elderly will not tell you they are thirsty if asked.  That is why it needs to be handed and encouraged multiple times a day.

Evaluation Frequency

We will recommend how often a Care Coordinator should stop by to evaluate the client and observe their condition and changes in care needs.

Activities/Exercise

We develop a plan of physical and mental activities that are appropriate and enjoyable to the client. 

Ambulation/Mobility/Transfers

Many of our clients have special needs related to their ability to safely transfer to and from seated positions. In addition, many use canes or walkers, or may simply need “stand-by” assistance as they ambulate. 

Bathing/Dressing

Personal grooming and assistance with dressing are thoroughly addressed.

Family Care

This is a general area that addresses many types of issues of family members, such as need for communication, special requirements for the safety and well-being of their loved-ones, and special instructions for care.

General Overview

All of our clients are evaluated by the Care Coordinator, and a general overview of the client, their living environment, needs, abilities, temperament, and much more are addressed.

Intro Location

When we introduce a caregiver into a home for the first time, our Care Coordinator will meet the care attendant in designated spot before they enter the home to begin the review of the care plan and the clients special needs.

Light Housekeeping

We spell out the specific housekeeping duties to be performed on each shift.  Our housekeeping duties are focused to the care need and main living areas of the client.

Bed-Bound Client Concerns

If a client is confined to a bed, a special protocol will be enacted (as directed by their medical professional) to reduce the risk of bed-sores and ensure proper hygiene and circulation.

Medical Conditions

While we are non-medical in our care focus, a review of medical conditions is crucial to understanding the special care needs of each client.  We will interface with client’s medical professionals and family to understand fully what assistance these conditions may necessitate, and to develop appropriate responses to changes in conditions or emergency situations.

Medications

Many of our clients request us to provide medication reminders, and to keep records of when a client takes their medication. 

Pets

We need to know what pets are in the home and their temperaments as well.  This helps us in selecting appropriate caregivers.

Psychosocial/Behavior

This area of the care plan addresses a wide range of issues that can affect a client.  This could include Alzheimer’s/Dementia behaviors, general temperament, medication side-effects, etc.  A plan for handling specific behaviors, as well as identifying caregivers skilled in handling special situations is addressed in this area.

Emergency Contacts and Medical Contacts

We identify all important contacts in the event of an emergency, as well as special instructions for handling emergency situations.

Sleep Patterns

Establishing a baseline of “normal” helps our care staff understand when sleeping/drowsiness may indicate a change of condition that needs to be brought to the attention of the family.

Spouse or Significant Others

We identify who else is in the home, key family members, and individuals the family wants to have access. 

Toileting/Incontinent Care

We want to ensure that this basic human need is adequately addressed.  Seniors often need special assistance, and our caregivers are specially trained to provide whatever the senior may require.

Transportation/Errands

Often we are called upon to provide transportation to and from appointments, or to run errands for the senior.  These are addressed so that we can provide a caregiver with appropriate transportation and insurance.  If permitted by family, we can also drive the senior in his or her own vehicle, or arrange for special transportation.

Durable Medical Equipment

We assess any special equipment that is in the home to ensure that our caregivers are properly trained to use it.  This could include hospital beds, wheelchairs, transfer boards.  While this equipment is usually arranged for by the client’s medical provider, Amdal In-Home Care can also assist in obtaining equipment and devices that assist in client safety and allows for increased comfort.

 

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