How to Use This Guide

Getting Started is Easy

Our guide is organized into 3 primary sections and identified by color tabs:

1. At Home Care & Health

This section offers two comparison spreadsheets/ grids One for Home Health Medical Care and another for In-Home Personal Assistance

First, familiarize yourself with the different levels of care offered by each license type We have included home care definitions to assist you in finding the care that best serves your needs This section also includes additional homecare resources and caregiver registry services

2. Community Resources & Services

This section is alphabetical and includes hundreds of services and organizations that work with older adults, those with disabilities and their families This section includes everything from Caregiver Resources, Social Security, Care Management, Senior Centers, Upcoming Events, etc

3. Housing

Begin by reviewing the Housing Definitions at the beginning of the section to determine which level of care best fits your needs Then turn to the easy to read comparison grids; which are separated into 5 primary care levels: Independent Living, Assisted Living/Residential Care, Adult Foster Homes, Memory Care & Skilled Nursing/Intermediate Care The communities are separated by county so you can quickly search a specific geographic area If you are unsure where to begin you may want to contact a Housing Placement & Referral Specialist found at the beginning of the housing section

Home Care Definitions:

Behavioral Health can include the prevention, intervention, treatment, and recovery support to people with addiction and mental health needs. Behavioral health may also include care for patients with memory loss and confusion, but typically includes more intensive treatment and intervention than simple redirection.

Homecare agencies provide non-medical services. Personal care may include: dressing, feeding and personal hygiene to facilitate self-care; homemaking such as housekeeping, shopping, meal preparation, and transportation; or respite care to provide support to the family. The Department of Health licenses home care agencies.

Home Health Care includes skilled nursing services, physical therapy, occupational therapy, speech language therapy and medical social services. A home health care agency may choose to be Medicare certified to be reimbursed for their services. Home health agencies may also teach you how to care for yourself.

In-Home Care/Personal Care is care related to activities of daily living. Care may be provided by Home Health or Homecare Agencies. These services are typically not covered by medical insurance or Medicare and do not require a physician’s order.

Intravenous Therapy is any medical treatments/medications that need to be introduced to the body via a patient’s veins. Numerous IV Therapies can be provided in-home under supervision of an MD. Some of these include: inter-infective/antibiotic therapies, hydration therapy, pain management, chemotherapy and central line care and maintenance.

Master of Social Work (MSW) is a master’s degree in the field of social work. MSWs help promote more integrated care with education and collaboration among care providers and support services.

Medicaid Certified A joint Federal and state program that helps with medical costs for some people with limited income and resources. Medicaid Certified facilities can offer services to individuals receiving Medicaid benefits in exchange for reimbursement from Medicaid. Some people qualify for both Medicare and Medicaid (these people are called “dual eligibles”).

Medical Social Services are assistance with social and emotional concerns related to an illness including counseling or help finding community resources.

Medicare Certified facilities can offer services to individuals receiving Medicare benefits in exchange for reimbursement from Medicare. A physician’s order is required to be reimbursed by Medicare. Medicare is a Federal health insurance program for those 65 and over or for those who meet other criteria.

Nurse Delegated Tasks a licensed registered nurse may delegate specific nursing care tasks to qualified nursing assistants in community-based and in-home care settings. One task taught and delegated to one caregiver for one client. Before delegating a task, the registered nurse delegator must determine that specific criteria are met and ensure that the patient is in a stable and predictable condition.

Psychiatric Services refers to the agency's ability to offer services related to psychiatric support with the prevention, diagnosis, and treatment of mental illness. Services may include counseling or administering of medications.

Respite Care is short-term or temporary. It is designed to give families a break from the stress of daily caregiving. Respite care can be for a few hours, overnight, or for days. The amount of care changes with the needs of the family and the ill or disabled person.

Skilled Nursing requires the oversight of a staff nurse and may include: rehabilitation, wound care, therapy services, or other medical care. These services are typically provided by a licensed Home Health Agency. This is different than Nurse Delegation services that may use a third party agency or consultant to delegate as needed for an individual specific need.

Therapy Services (OT, PT, RT, ST)

Occupational Therapy (OT) refers to services to assess and treat patients to help them develop, recover, or maintain daily living and work skills. Occupational therapists help clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function.

Physical Therapy (PT) refers to services for the treatment and rehabilitation process where a physical therapist will often stretch, strengthen, facilitate muscles, challenge balance, test coordination abilities, teach home exercise programs to enhance basic mobility skills; to help lessen disability and pain and improve overall function and quality of life.

Respiratory Therapy (RT) refers to services for care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. It may include the therapeutic use of medical gases and their equipment, humidification, aerosols, ventilator support, bronchi pulmonary drainage and exercise and respiratory rehabilitation.

Speech Therapy (ST) refers to services to assess and treat speech and swallowing disorders. Speech therapy can treat speech, language, cognitive skills or swallowing.

Wound Ostomy Continence Nurse (WOCN) WOC nurses have advanced training in acute and chronic wound care as well as the physical, emotional, and social issues of patients with ostomies (those who have had some kind of bowel or bladder diversion), stomas, acute and chronic wounds, and incontinence (those with bladder and bowel control and associated skin care issues).

Sources: Department of Health & Human Services, Administration on Aging and National Institutes of Health.

Includes skilled nursing services, physical therapy, occupational therapy, speech language therapy and medical social services. A home health care agency may choose to be Medicare certified to be reimbursed for their services.

AccentCare Home Health 2 , 691 Murphy Rd #236, Medford, 97504

Three Rivers HomeCare 2 , 555 NE 'F' St #B, Grants Pass, 97526

1 CHI Mercy Hospice is affiliated with Mercy Hospital (Mercy Healthcare Inc operates Mercy Hospice)

2 The following providers are affiliated with the Asante Health System: AccentCare Home Health & Palliative Care of Rogue Valley; Asante Hospice; Asante Ashland Community Hospital Home Health/Hospice & Palliative Care; Southern Oregon Home Health; Three Rivers HomeCare

3 Sky Lakes Home Health is affiliated with Sky Lakes Hospital

4 Providence Home Health is affiliated with Providence Medford Medical Center

*The Home Health Agency you choose is responsible for all the supplies and services including physical therapy, occupational therapy, or speech therapy needed under your Home Health Plan of Care The exception to this requirement is limited to durable medical equipment such as wheelchairs, hospital beds, and oxygen tanks Other providers cannot bill Medicare for the items or services that are covered under your Home Health Plan of Care Please discuss your needs with your Home Health nurse prior to purchases to avoid additional expense for which you may be held responsible

*The Skilled Nursing Facility and Home Health provider list information was obtained from the cms gov website on March 2023 and compared to ADRC and Oregon Department of Health and Human Services

Acronyms for Long-Term Care:

AAA Area Agency on Aging

AARP American Association of Retired Persons

AD Alzheimer’s Disease

ADL Activity of Daily Living

AFH Adult Family/Foster Home

AL Assisted Living

ALF Assisted Living Facility

AOA Administration on Aging

APS Adult Protective Services

CCRC Continuing Care Retirement Community

CHF Congestive Heart Failure

COPD Chronic Obstructive Pulmonary Disease

CPR Cardiopulmonary Resuscitation

DHSSPD Department of Human Services, Seniors and Persons with Disabilities

DHS Department of Health Services

DNR Do Not Resuscitate

DSS Department of Social Services

ED Emergency Department

EMS Emergency Medical Services

ER Emergency Room

H&P History and Physical

HIPAA Health Insurance Portability and Accountability Act

I&R Information and Referral

ICF Intermediate Care Facility

ICU Intensive Care Unit

IHSS In-Home Supportive Services

IL Independent Living

ISP Individual Support Plan

JCAHO Joint Commission on Accreditation of Healthcare Organizations

LOC Level of Care

LTAC Long-Term Acute Care

LTC Long-Term Care

MAR Medication Administration Record

MMA Medicare Prescription Drug Improvement and Modernization Act

MMSE Mini-Mental State Examination

N4A National Association of Area Agencies on Aging

OT Occupational Therapy

PACE Program of All-Inclusive Care for the Elderly

PERS Personal Emergency Response System

POA Power of Attorney

POLST Physician Order for LifeSustaining Treatment

PRN Pro re nata (commonly used to mean “as needed” in Latin)

PT Physical Therapy

QA Quality Assurance

SHIP State Health Insurance Assistance Programs

SLS Support Living Services

SNF Skilled Nursing Facility

SPD Seniors and People with Disabilities

TCU Transitional Care Unit

TPN Total Parenteral Nutrition

URAC Utilization Review

Accreditation Commission

UTI Urinary Tract Infection

VA U.S. Department of Veterans Affairs

WHO World Health Organization

Information provided by: Retirement Connection www.RetirementConnection.com

Tips for Engaging Patients with Alzheimer’s Disease

Whether you’re caring for a loved one with Alzheimer’s disease or you are a caregiver looking after a patient, it can be challenging to care for someone with memory loss. While Alzheimer’s Disease has varying stages, many patients start to find themselves losing train of thought, have difficulty finding the right words, and even start to speak less often. We’re sharing some tips to help you engage with people with Alzheimer's disease and minimize communication challenges.

Talk directly

It’s easy for people with Alzheimer’s to get overwhelmed and confused. To reduce this, talk slowly and clearly while making eye-contact with the patient. If possible, try to minimize distractions and background noisesuch as pausing music or the TV while speaking.

Patience

It can take a bit more time for people with Alzheimer’s to process what they are hearing and how they want to respond. Be patient in waiting for their response and offer reassurance. Don’t interrupt them but instead encourage them to take their time in responding.

Be Clear

Rather than asking open ended questions, ask questions with direct or yes and no answers. For example, rather than asking what do you want to do today? Ask, would you rather go for a walk or start a puzzle? This helps the patient to be less overwhelmed and easily answer.

Be Visible

When possible, always approach a person with Alzheimer’s disease from the front, rather than from the side or behind. Try making eye contact, smiling, and matching the person's mood when appropriate.

While the challenges of communicating with someone suffering from memory loss are always evolving, we hope these tips help to ease frustrations and improve communication. Remember to be patient and don’t hesitate to get help if needed.

Article provided by: New Horizons In-Home Care 541-507-1234 www.NHCares.com

How to Avoid Caregiver Burnout

Caregiving can be a deeply rewarding experience, but it can also take a significant toll on the caregiver's physical and emotional well-being. Caregiver burnout is a condition that can occur when caregivers are exposed to chronic stress and strain without proper support or self-care.

Caregiver burnout can manifest in a variety of ways. Physical symptoms may include chronic fatigue, headaches, and muscle tension. Emotional symptoms may include depression, anxiety, and feelings of helplessness. Caregivers may also experience a decrease in their own quality of life, as they may have less time to pursue their own interests and hobbies.

One of the biggest contributors to caregiver burnout is the lack of support and respite care. Caregivers often feel a sense of responsibility to provide care 24/7, which can be physically and emotionally draining. It's important for caregivers to recognize that taking time for themselves is not a sign of weakness or neglect, but rather an essential part of maintaining their own well-being.

Many caregivers are thrown into their role without any formal training or support, which can make it difficult to navigate the complex medical and emotional needs of their loved ones. It's important for caregivers to seek out resources, such as support groups and educational materials, to help them feel more confident and competent in their caregiving role.

It's also essential for caregivers to practice self-care on a regular basis. This may include engaging in activities that bring them joy, such as exercise, meditation, or spending time with friends and family. It's important for caregivers to prioritize their own health and well-being, as this can ultimately lead to better care for their loved ones.

If you or someone you know is experiencing caregiver burnout, it's important to seek help. This may include reaching out to a healthcare provider, joining a support group, or seeking counseling. It's essential to recognize that caregiver burnout is a real and serious condition and that seeking help is a sign of strength, not weakness.

In conclusion, caregiver burnout is a common and serious condition that can have significant impacts on caregivers and their loved ones. It's essential for caregivers to prioritize their own well-being and seek out support and resources to help them navigate their caregiving role. With proper support and self-care, caregivers can continue to provide the important and valuable care that their loved ones need.

Article provided by: Home Instead

541-734-2700 www.HomeInstead.com/476

Advocacy

ADRC of Douglas County, (Ad pg #31)

1036 Douglas Ave #221, Roseburg, 97470 541-440-3677, 855-673-2372

American Association of Retired Persons (AARP), 601 'E' St NW, Washington DC, 20049 888-687-2277

Battered Persons' Advocacy, 1202 SE Douglas Ave, Roseburg, 97470 541-673-7867, 800-464-6543

Consumer Advocacy Unit of Oregon Consumer Office, 350 Winter St NE, Salem, 97301 888-877-4894

Cow Creek Band of Umpqua Indians, 2371 NE Stephens St #100, Roseburg, 97470

Disability Rights of Oregon, 511 SW 10th Ave #200, Portland, 97205

Fair Housing

541-672-9405, 800-929-8229

503-243-2081, 800-452-1694

Senior & Disability Services

is the local Area Agency on Aging that o ers many programs for older adults, adults with disabilities, and their caregivers in Josephine & Jackson counties including:

ADRC Aging & Disability Resource Connection

Any family member, friend, caregiver, or individual may contact the ADRC (website or phone) to learn abut resources & options available in Jackson & Josephine Counties to help seniors & adults with disabilities. Trained & certi ed sta assesses consumer needs over the phone or in-person to help them understand their service options & empower them to make informed decisions.

Options Counseling

Facilitating person-centered decision-making & resource planning

A supportive, proactive & interactive no-cost counseling service that helps seniors & families make informed decisions about meeting current & future long-term care needs. Counseling is provided by phone, email or in-persion.

Local Associations

ALS Association (Lou Gehrig's Disease)

Douglas County, PO Box 22653, Eugene, 97402

Southern Oregon, 2305 Ashland St, Ste 'C' #458, Ashland, 97520

Alzheimer's Association – Oregon, (Ad pg #37)

American Diabetes Association – Oregon, 4380 SW Macadam St #270, Portland, 97239

800-272-3900

503-736-2770, 888-342-2383

American Heart Association – Oregon, 4380 SW Macadam St #480, Portland, 97239 503-820-5300, 800-242-8721

American Parkinson's Disease Association

800-223-2732

Arthritis Foundation – Oregon Branch Office, 4145 SW Watson Ave #350, Beaverton, 97005 800-283-7800

Cystic Fibrosis Foundation – Oregon Chapter, 2701 NW Vaughn St #203, Portland, 97210 503-226-3435

Douglas County Cancer Services, 2880 NW Stewart Pkwy #202, Roseburg, 97471

Epilepsy Foundation NW,

541-440-9409

541-990-1246

541-292-8775