A great question arose as a result of the Ontario Retirement Home blog: Bathing Supports for Ontario Residents in a Retirement Home...Cost Savings Tip
In order to provide the most comprehensive answer, this post addresses tips to improve the quality of your CCAC home visit, as well as suggestions as to how to proceed if an Elder does not currently qualify for bathing supports.
When booking that first CCAC appointment, the most important question to ask yourself is...
Are there barriers to a CCAC Case Coordinator accessing a full and complete history that will impact the eligibility decision for bathing supports?
Think about it…
Some Elders will not be fully forthcoming or may downplay their difficulties when asked about completing their own physical care. This may be the result of pride, the desire for privacy, fear regarding the outcomes of expressing a need, changes in mood, or potentially a lack of insight into their difficulties. If there are memory issues, an Elder may be convinced that they are engaging in regular bathing, when in fact this is not the case.
Why does this matter...
The CCAC Case Manager sees someone for a snapshot in time, and on occasion it can be difficult to separate expressed ability from actual ability.
Tips to Make Your CCAC home visit comprehensive…
Tip: Elders may benefit from having a trusted loved one attend the appointment to assist with the delivery of the medical and self -care history. As the Power of Attorney for Health, or chosen confidante, your attendance should be discussed with your loved one prior to the meeting. Respectfully cueing your Elder so as to highlight current difficulties, may provide the added information needed regarding eligibility for bathing supports.
Tip: If a Client has memory loss or mental health issues, there may be the involvement of a Family Support Counsellor from the Alzheimer Society or other visiting healthcare professionals that regularly see the Elder in the community. Asking for a collaborative visit may provide additional insight into the Elder's ability to manage facets of self care.
Tip: One area where bathing supports are red flagged is incontinence issues. If an Elder has difficulty with bowel or bladder leakage, this can be a cue for the CCAC that care assistance to prevent skin breakdown may be warranted. The inclusion of this information in the health history may be embarrassing, but it is relative and important.
Tip: Prior to the CCAC visit, make a list of all medical conditions, surgeries, and have available the medications that are currently taken, (including herbs, vitamins and over the counter drugs), or provide a printed list from the pharmacy. This information will provide greater insight into the Elder’s current level of wellness. It is prudent to have the names and telephone numbers of any care providers, a history of recent care visits, and any outcomes as a result of these medical appointments. These pieces of the puzzle aid in creating a thorough history that will be of great assistance to the CCAC team member.
How can I get further help if CCAC does not qualify an Elder for bathing supports?
Tip: The Elder does have the right to request further consultation by calling the CCAC if care services have been denied and they would like a further telephone consultation, review and clarification.
Tip: Your family doctor may also initiate a referral to CCAC if there are medical concerns about an Elder’s ability to perform the activities of daily living.
Tip: The CCAC Case Coordinator can provide additional information about the availability of possible community care supports available, aside from their services. (Fees may apply)
Tip: Many Retirement homes do provide bathing supports and there is generally no criteria to receive this additional care. However, this is a fee for service option.
Tip: The CCAC can provide an Occupational Therapist to attend the Elder’s residence to make suggestions regarding possible safety grab bars in the bathroom to aid with bathing and assist with toileting. The follow up purchase, installation and costs associated with these items is incumbent upon the Elder. The Occupational Therapist may be able to address simple modifications to the process of self-care so that the Client can complete bathing independently.
Tip: Having a free Meds Check Review by your pharmacist is a prudent measure to insure that prescription drugs are not reacting with over the counter medications. Are there medication interactions which are causing unwanted side effects and subsequently affecting ability? A good rule of thumb is to discuss OTC (over the counter meds) with your pharmacist before purchase.
Tip: Are abilities to conduct self care being hampered by reduced strength and mobility? Is there a Senior’s geared program to promote strength and balance in your Retirement Residence or community? (Always check with your Doctor before starting any form of exercise.)
Tip: In all cases, be your own best advocate: Keep your CCAC Case Coordinator informed of any health or ability changes that evolve over time. A prudent health wise consumer learns to be a great communicator.
In summary, although not all Elders will qualify for bathing assistance during that initial home visit, there are strategies to pursue that may improve your access to care.