The medical and companionship services Mildred Bachman receives from Personal Touch Home Care allow her to continue to live with her son Michael.

Mildred’s fall was the first of several health problems that resulted in her moving into Michael’s home. “It’s nearly impossible to envision the amount of stress and upheaval bringing an elderly parent into one’s home can be—especially when it was a sudden, unexpected event with multiple layers of health issues involved,” he said.

After his mother started living with him, Michael realized that other health problems and her diminishing memory were going to prevent her from returning home. Unsure where to turn, he started researching home care agencies. His research led him to Personal Touch Home Care. “They really just seemed to have their act together,” he said. Personal Touch offered a unique blend of medical services and companionship. “So many of the other agencies were just focused on medical needs, and that wasn’t really what I was looking for,” Michael recalled. “I needed some degree of health services, but I really also wanted social and companionship services.”

Personal Touch assessed Mildred’s needs and devised a care plan that focuses on improving her quality of life. “They have helped her maintain her independence and continue doing the things she was already doing.” Michael said. With the help of her aide, Andrietta Allen, Mildred does puzzles, sketches and takes regular walks. She also received physical therapy and has regained full use of her wrist.

“After Personal Touch started helping us, things got so much better,” Michael said. “So many of my biggest fears about my mother living with me turned out to be non-issues.” He added, “Something that seemed insurmountable and impossible became a routine, then actually enjoyable.”

Today, Michael and Mildred are both comfortable and happy with their living situation. It still requires a lot of work from Michael and his partner Jerome, but with the help they receive from Personal Touch, they are able to maintain busy work schedules while Mildred enjoys the hobbies and activities she has always loved.

Today, sitting in the home the couple has shared for more than 50 years, Betty Jane laughed as she recalled their uncommon love story. “We’ve really been together since kindergarten,” she said. As they grew older, the pair’s friendship deepened. Soon the two were dating, and when they turned 21, Betty Jane married Creston.

When Bessye Clay (right) utilized the services of a home health agency, she not only received the care she needed, but found companionship with Registered Nurse Angela Lewis.

After different careers in public service, Baltimore City resident Bessye Clay eventually found herself needing a helping hand.  In June 2010, the North Carolina native, known to her family and friends as ‘Miss Bessye,’ had undergone back surgery.

Desiring to return home, it was clear Miss Bessye would need the assistance of a home health care agency when she was discharged from the hospital.

“I didn’t have any problems with the hospital,” she said.  “But I’d rather be in my home.  It’s more comfortable.”

Fortunately, her doctor referred her to P-B Health, an agency that provides skilled nursing, therapy services, medical social work and personal care.  With the agency, Miss Bessye not only received the care and support she needed, but she found companionship.

Angela Lewis, a Registered Nurse who has been with the agency for 14 years, provided wound care for her surgical incision and Miss Bessye also received physical therapy services.

“The nurses would come out and help me with walking and I did all kinds of therapy with them,” said Miss Bessye.

She has also credited Angela with helping her to avoid what could have been debilitating injuries after she slipped and fell in her home last September.  As a result, Miss Bessye has suffered from sciatica, but said things could have been worse had it not been for Angela checking on her and insisting she go to the hospital.

“If she hadn’t insisted that I go, I might not be able to walk right now,” said Miss Bessye.

Thanks to P-B Health, she made her recovery much quicker than expected and would gladly recommend the agency to others.  With the improvement of her health, however, there has just been one downside for Miss Bessye.

“I wish Angela was still coming,” she said.  “I miss her very much. She was an excellent nurse.”

These days, Miss Bessye enjoys spending time with her family in the area and catching up with Dot, a friend she had made in the hospital who also received care from the home health agency.

“Some of the same nurses that came to see me went to see her,” said Miss Bessye.  “We now call each other every day.  We are always laughing and talking about the great service we have had.”

Excerpts reprinted with permission from the article, ‘The Growing Need for Home Health Care Services’ by Ursula Battle in “The Baltimore Times” (December 3-9, 2010). 

“I’m in New Jersey and my family’s in Maryland,” she said. “I’m truly isolated with not much of a support system of my own.”

This living situation became more difficult when Liz’s mother indicated she was having health problems. She was eventually diagnosed with Stage III Uterine Cancer, for which she immediately had surgery at Johns Hopkins.

Liz knew how much her father and her brother, who had undergone a lung transplant, relied on her mother and felt it was time to make a decision.

“I insisted with my father that she needed someone to be at the house to help her,” she said.

When she searched online for elder care services in the area, one of the results was Visiting Angels of Pikesville, a home care company that Liz remembered hearing about on the news. She then called Executive Director Dave Pyser and a mere two days after Liz’s mother was discharged, a caregiver arrived at their home.

The caregiver, Charlotte, helped Liz’s mother with everyday tasks such as preparing meals, providing medication reminders, bathing, making the bed and doing laundry.

“My mom absolutely loved her caregiver,” said Liz. “Her spirits were up, and she was ready to start her day knowing Charlotte was coming.”

Although her mother does not need the same level of care these days, Liz still has as much peace of mind knowing she can call Visiting Angels at any time.

“I was very fortunate that Dave had the name behind him, but also the professionalism and understanding,” said Liz. “He’s attentive to what the patients’ needs are.”

As the Boomer population grows and more adult children face similar difficult decisions, Liz urges them to seek these available services.

“My mom, dad and brother’s situation is the example of a family that needs that kind of resource available to them because anything can happen at any time,” she said.

However, Florence recently faced a major challenge that has tested her emotionally. She made the transition from living alone in a large home in Pennsylvania to Sunrise Assisted Living of Leesburg to be closer to her family. “It has been difficult, it hasn’t been easy — but with help from everyone I will get through it,” she said.

Mary Ellen Knecht, RN and Nurse Liaison with The Medical Team refers to these challenges as “transitional trauma.”

Fortunately, the assisted living community where Florence resides utilizes a unique research-based program designed to assist families and individuals facing mental health and behavioral challenges. The Journey Behavioral Home Health Program was developed by The Medical Team with a leading expert on psychiatric home care.

Providing solutions to the transitional challenges like those Florence has faced is just one of many behavioral aspects that it addresses. “When I learned about the Journey program, I was very interested in offering it to our residents, staff and families,” said Susan Balinger of Sunrise Assisted Living of Leesburg.

The program addresses a critical concern, as statistics show that over six million Americans over the age of sixty-five have some form of this emotional disorder, with nearly two million being clinically depressed.

Getting treatment is extremely important for individuals and families. According to the National Institute of Mental Health, only about 10 percent of seniors suffering from depression receive treatment. When treated, however, studies show that older patients respond well. A Pittsburgh Medical Center study found that 80 percent of seniors treated over a three-year period didn’t suffer recurrent bouts, while only 10 percent of those without treatment avoided relapse.

Knecht advised, “If you suspect that a loved one has behavioral health issues, such as Alzheimer’s, depression or bipolar disorder, it’s important to talk with their physician as there are programs with proven outcomes available to help them.”

Balinger continued stating, “The Journey program has given us all support to help ease our residents through difficult situations.” The program has not only been instrumental in improving the lives of those living in senior care communities, but also homebound elders.

Based on her own experience, Florence offered up advice to others facing similar transitions saying, “Welcome all the help you can get, have an open mind, be courageous, and be thankful.”

With the help of an attorney and care management organization, Elizabeth Dusa found a homecare agency that has provided her with the support she needs.

Families are there for each other to celebrate the good times and help each other through the challenging times. Elizabeth Dusa had spent a lifetime caring for her son, but when her health began to turn, he became her loyal and compassionate caregiver in return. Unfortunately, he passed away suddenly, leaving Elizabeth alone with no remaining family or support.

Elizabeth grew up in Pennsylvania and is of Hungarian descent. When her son was diagnosed with juvenile diabetes, she was urged to institutionalize him. Although she was a single mother, she adamantly refused and took measures into her own hands. Elizabeth kept his health under control by monitoring his diet and keeping detailed journals of everything he ate. As a result, she was able to keep him healthy.

While maintaining this focus on her son, she led a frugal lifestyle in Annandale, Va. working as a secretary. In a true success story, her son eventually received a PhD in Physics, became an astronomer and had a celebrated career with the FBI.

With no one to care for her following her son’s death, Adult Protective Services (APS) was called in to help Elizabeth. They in turn contacted Elizabeth “Liz” Gray, an elder law attorney who now serves as the guardian for Ms. Dusa.

“I had to clean out the house, get her settled in Fairfax Nursing Center, and make sure she was well cared for,” said Ms. Gray. “She was losing weight, she wouldn’t let anyone touch her, she would scream and cry regularly, and at times was very combative.”

Ms. Gray then hired Elder Care Consultants, a geriatric care management firm to assist her in monitoring and coordinating Elizabeth’s care. Ms. Gray and Dia Loken, the RN and Care Manager assigned to Elizabeth’s case, observed that she was more comfortable around male caregivers, which they attributed to her strong relationship with her son.

They felt that finding a dedicated male caregiver that she could trust might enable them to reduce the medications Elizabeth was on to control her anxiety and combativeness. The search was more challenging than expected, so Dia connected with BestCare Home Care where she was introduced to Hugo Ruiz-Menandez, a trained physician in his native country of Bolivia.

“The care he provides to Elizabeth is extraordinary and the bond that the two of them have is exceptional. They are referred to as a little married couple at Fairfax Nursing Center because they are together always,” said Dia. “Her quality of life has been enhanced.”

Dia and the other professionals involved in Elizabeth’s case cannot emphasize enough the positive change they have seen in her.

“It was almost daily that she was getting into a physical altercation with another resident,” said Vanessa Bishop of ElderCare Consultants. “Now she is in love with her aide and has really calmed down.”

According to Dia, they have even been able to reduce Elizabeth’s medications as she has been consistently gaining weight and is rarely sick. Hugo also gives her fantastic skin care and the mere sound of his voice seems to calm Elizabeth down.

“I am very impressed with the responsiveness and work ethic of the caregivers and management at BestCare,” said Dia. “There are so many home care agencies to choose from, and it’s important not to tolerate substandard care. I don’t second guess their attention and care.”

She explained how important it is to have a team approach to care, especially in medically-complicated situations. The team is tuned into changes and is able to report to the physician in a timely and accurate manner.

Now Elizabeth, who once seemed alone, has quite the caring support network and essentially a different kind of family that will continually be there for her.

“I fell in love with her when I met her because she was so feisty,” said Dia. “In fact I have a picture of her on my refrigerator. My family refers to her affectionately as ‘The Duce.’”

This was the case for Mrs. B, who was living in a townhouse in Northern Virginia that contained many flights of stairs. Not only was she losing mobility and experiencing several falls, but she had started showing signs of early dementia.

Although Mrs. B made the move to a nearby independent living senior apartment community that offered her a safer environment, her health and abilities continued to decline. When everyday activities became difficult, it was evident she needed additional services to maintain her independence.

It was HomeWell Senior Care that was called to help Mrs. B. Marc Lieberman, one of the principles in the home care agency, said, “Our care manager assessment discovered that she needed assistance with nearly every aspect of daily living.”

The level of care management and services that Mrs. B now receives goes beyond what most would consider typical home care. With her home being unoccupied since her move to the community, HomeWell has helped coordinate cleanup and maintenance of the property.

Even when it was recently suggested that Mrs. B move to a home that could offer assisted or nursing care, she has chosen to remain at the community with the in homecare she has been provided. “We discussed this with her, but she is happy where she is and does not want to move,” said Lieberman, who even confirmed with Adult Protective Services that it was a sound decision.

Since the home health agency came into her life, those around Mrs. B have seen improvements in her demeanor and her overall acceptance of needing additional support to remain independent. Especially significant has been the strong bond between Mrs. B and her caregiver of nearly two years, Kate Brown.

While Kate shares that her work can sometimes be challenging, she said of Mrs. B, “I love her like my own family.” And for an individual who was without family in a time of need, these words have a truly special meaning.

Karen Briskie, director of THE MEDICAL TEAM’s _Journey_ Behavioral Home Health Program, says, “Grief is a natural process, an intense fundamental emotion, a universal experience which makes us human. Grief itself is a normal and natural response to loss. It is important to realize that acknowledging the grief promotes the healing process.”

Grief should not be labeled as clinical depression and does not generally warrant the use of antidepressants as Page Moss Fletcher, MD, a Northern Virginia board-certified in geriatric psychiatry, adds, “A very important point is that grief and loss are a common human experience and can be helped with therapy. Clinical depression is a medical problem that is treatable with medication, therapy and support.”

According to Dr. Fletcher, pursuing active treatment can help those with clinical depression or persistent grief get back to enjoying life and minimize the risk of medical problems or in the worst case, suicide. “Untreated depression can lead to stroke, heart attack and other medical problems,” he says. “Getting treated helps minimize the chances of other medical problems worsening.”

Seniors today have many challenges to face as they begin to age and retire. There are many options for seniors when it comes to having less independence. Retiring from a longtime job, experiencing the passing of loved ones, or eventually losing their independence, seniors face difficult situations and many losses. The National Institute of Mental Health indicates that only about 10 percent of seniors suffering from depression receive treatment. Many seniors do not seek treatment or feel comfortable discussing depression and loss with their physicians. When depression is treated, numerous studies show that seniors respond very well. For example, a Pittsburgh Medical Center study found that 80 percent of seniors treated over a three-year period didn’t suffer recurrent bouts.

Fortunately, there are programs that can provide solutions and treatment for a variety of behavioral health issues.

THE MEDICAL TEAM developed one such specialty program with a nationally-recognized expert on psychiatric home care. The company’s _Journey_ Behavioral Home Health Program is a program to which Dr. Fletcher regularly refers individuals in order to keep them living independently in their homes.

The unique research-based program is known for helping those who are becoming isolated in their homes and addressing the mental health and behavioral challenges associated with grief and loss, transitional trauma, depression, in addition to other behavioral health diagnoses.

No matter one’s age, life does present unexpected challenges and individuals facing emotional and behavioral challenges are certainly not alone. Help from certified professionals and programs can provide treatment with solutions and play an instrumental role in improving lives.

One such example is that of Bertha Siegel. Initially a full-charge bookkeeper, she went on to own a company in Baltimore with her husband. The couple did not have children and were married for 61 years before his passing.

Down the road, Bertha became sick and as a result was hospitalized and later admitted to a rehabilitation facility.

“When I was ready to leave the rehabilitation center, they told me I would need 24-hour care and referred me to Genesis SelectCare,” said Bertha.

This home healthcare company has since provided Bertha with two live-in caregivers named Sandra and Annette, whom she says she would not trade for anything.

“They provide any kind of care you need,” she said. “They’re absolutely marvelous.”

With the security of having help available around the clock, Bertha has peace of mind and receives any assistance she may need with the activities of daily living.

There was one incident in particular where Bertha had an emergency and Sandra and Annette made all of the arrangements to get her back to the hospital. “They saved my life,” she said. “There’s nothing more I can say – they’re perfect.”

As a result, Bertha would recommend utilizing a home healthcare company, particularly Genesis SelectCare, to anyone. She credits her provider especially for a great job in assigning her with two excellent caregivers.

“It’s really an efficient organization,” she said. “They take good care of everything and never leave you in midair wondering what’s going on.”

Though times seemed difficult following her husband’s passing, Bertha has felt very fortunate having found caregivers who not only offer her the necessary assistance, but have become friends in the process. Being able to remain in the comforts of her home while surrounded by trusted individuals has made her story one of success.

“We know people love their homes, and want to stay in their homes for as long as possible. That is why it is so important to make simple changes to be safe and comfortable in your home,” says Elinor Ginzler, Director of Livable Communities at AARP. “There are easy and inexpensive ways to update your home to accommodate everyone and you don’t have to be an expert to do it. The earlier you start identifying and planning for improvements, the better your chance of enjoying your home for years to come.”

h3. Reasons Why Seniors Choose to Stay in their Homes

There are a variety of reasons why those 50 and older want to stay in their homes:

* Attachment to their home and neighborhood
* Close ties to friends, family and neighbors
* Proximity to favorite amenities, such as a grocery store they love, a cleaner they’ve always gone to or a favorite walking trail

Seniors can face physical challenges that can make it difficult, and sometimes impossible to stay in their homes without some degree of change to their environment. In fact, studies indicate that half of all falls happen at home and research suggests that one-third of home accidents can be prevented by easy home updates and preventative maintenance.

h3. Features to Avoid When Planning for Retirement at Home

* Low lighting
* Stairs with no handrails
* Loose area rugs
* Entrances with many steps
* Hard-to-grasp faucet handles and door knobs
* High cabinets

However, just as we do, homes themselves age too. It’s important for homeowners to make updates to ensure that their home remains a safe and comfortable environment. You wouldn’t skip out on your annual physical, so you shouldn’t neglect to assess your home.

h3. Steps to Make a Home Safer for Seniors

Aging parents, as well as their adult children, can take advantage of the fall season to prepare home for the winter season and holiday guests. Older adults and those who want them to feel safe and comfortable, can take easy, inexpensive steps to make home the ‘sweetest’ it has ever been.

The following 10 steps can make home a safer and more comfortable place:

# Install handrails on both sides of all steps (inside and outside)
# Secure all carpets and area rugs with double-sided tape
# Install easy-to-grasp shaped handles for all drawers and cabinet doors
# Use brighter bulbs in all settings
# Install nightlights in all areas of night activity
# Add reflective, non-slip tape on all non-carpeted stairs
# Install lever handles for all doors
# Place a bench near entrances for setting down purchases and resting
# Install closet lights, as well as adjustable rods and shelves
# Install rocker light switches and consider illuminated ones in select areas

Local hardware stores carry many of the products to make simple updates to homes for the aging. For more extensive renovations, homeowners should consider hiring a contractor who is licensed, certified and bonded to do work in that particular location.

h3. Things to Consider When Purchasing a New Home for Retirement

For those who are considering purchasing a new home for their retirement, assessing its livability is critical before making a purchase.

* Is there a step-free entrance into the central living area of the home?
* Are the doorways wide enough to move in a big-screen TV, or in some cases, a wheelchair or walker?
* Is there a bathroom and bedroom on the main floor?
* For a loved one with mobility problems, can the bathtub, toilet and shower be easily accessed?

These are just a few questions older adults should consider asking as they prepare to buy, ensuring that their retirement home will support them comfortably as they age.

AARP offers a wealth of information to guide homeowners in retrofitting and updating their home. To learn more about home design and how to evaluate your home, visit www.aarp.org/homedesign.