Home Hospice Tips

When considering hospice care, families are often unsure about what to expect. Hospice is a great service with many dedicated nurses, doctors, caregivers, and team members. However, when tasked with providing home hospice care many families lack the experience needed to make informed choices.

What is Home Hospice?

Home hospice care is a compassionate and invaluable service that provides specialized medical, emotional, and spiritual support to individuals facing life-limiting illnesses in the comfort of their own homes. It is a holistic approach to end-of-life care that focuses on enhancing the quality of life for both patients and their families.

Home hospice teams typically include skilled nurses, social workers, chaplains, and volunteers who work collaboratively to address the unique needs and preferences of each patient. Through Home Hospice services they offer pain and symptom management, emotional counseling, and guidance on making informed decisions about treatment options and advance care planning.

One of the key benefits of home hospice care is the ability to maintain a sense of familiarity and security for patients and their families during a challenging time. Patients can receive care in a setting that is not only physically comfortable but also emotionally comforting, surrounded by loved ones and familiar surroundings. This approach not only helps alleviate physical suffering but also provides emotional and psychological support, ensuring that patients can spend their final days with dignity, peace, and a sense of control over their care.

Home hospice care allows individuals to create meaningful memories with their families and friends in a setting that holds personal significance, offering a compassionate and dignified way to navigate the end-of-life journey.

What do we know about hospice care?

Abby Services of Fort Myers and Cape Coral has been helping families find caregivers to assist with in-home care since 1997. With the help of a private professional caregiver, individuals can have the in-home care and support they want and need to remain safe and supported.

Abby Services is owned and operated by a former hospice nurse Scott Strachan. Through his experience as a nurse and caregiver, Scott is able to help provide the insight and support to help guide families seeking home hospice care.

Top 3 hospice tips from a former hospice nurse.

Home Hospice tip #1: Hospice is a resource, use it.

Hospice is a valuable resource. However, it can only assist those willing to receive their support. Hospice has an undeserved stigma to many that leads them to refuse to seek the support hospice provides.

While this stigma is understandable, families should genuinely consider the benefits hospice provides. The benefits of hospice should be considered when appropriate and available. This is especially true for home hospice care.

To be considered a candidate for hospice care an individual requires a doctor to certify their illness is terminal and that they have 6 months to live.

This can be a difficult reality to confront however these guidelines can be fluid. It is recommended that families have a conversation with a hospice professional to discuss their specific situation.

Scott Strachan reports that he has had hospice patients who have received hospice care for years. Families also have to recognize that should they choose, they can stop hospice care at any point and resume traditional treatment.

Home Hospice tip #2: Hospice can provide many necessary supplies. Here are the supplies many families don’t consider.

Hospice provides many supplies necessary for an individual’s care and comfort. Having access to these supplies is especially important for those receiving at-home hospice care.

Even with all of the materials and support provided by hospice, there are common items that can help families providing home hospice care that are not provided. These items can help create a calm, comfortable, safe atmosphere for those receiving home hospice care.

• Sound Machines: Sound machines generate white noise. They can mask outside noises. When in use they promote a calm restful environment that limits outside disturbances and interruptions.
• Baby Monitor: Baby monitors are cheap and effective ways for families and caregivers to monitor a home hospice patient without ‘hovering”. Baby monitors allow hospice caregivers to monitor an individual’s safety and needs from a distance.
• Scent: Scent plays a major role in creating a calm and restful environment. Scent can be managed with candles, scent diffusers, or other products. The importance of scent should be considered when planning home hospice.
• Baby Powder: Many receiving home hospice may be bed-bound or have limited mobility. This can be uncomfortable and make an individual restless. Baby powder can help to promote comfort and is something many fail to consider.
• Bell on clothespin: This is something Scott Strachan learned as a private caregiver. The purpose of the bell and clothespin is similar to a baby monitor. They both allow hospice caregivers to monitor their patients without being physically present at the bedside. Falls can quickly and easily happen without warning. A clothespin with a bell attached to blankets or sheets notifies a caregiver when a hospice patient moves. This can notify the caregiver if an individual needs their attention when a patient does not or can not communicate their need for support.
• Pillows, pillows, pillows: A core focus of hospice care is comfort. Individuals receiving home hospice care may need frequent repositioning to promote comfort and rest and minimize injury. This often requires more pillows than are commonly used. Having pillows available can help your home hospice caregiver provide excellent support.

Home Hospice tip #3: Hospice cant do it all.

The care, attention, support, and resources provided through in-home hospice are amazing. That being said, those receiving in-home hospice care may require more support than is provided by hospice.

Additional care and support may be provided by a spouse, friend, or family member. When an individual requires more care (or a family member providing support needs more rest) a private professional in-home caregiver may be considered.

Do you have home hospice questions?

If you or your loved one is considering seeking hospice support in Fort Myers and Cape Coral we can help find affordable home hospice care. Just call 239-590-0861 to learn how Abby Services can help!

Plastic Surgery Postoperative Care

Are you having plastic surgery in Fort Myers, FL, or Cape Coral, FL? If so, you should consider your plastic surgery postoperative care plans. You may need the help and support of a professional caregiver from Abby Services.

Why would you need plastic surgery post operative care?

Plastic surgery postoperative care plays a crucial role in ensuring optimal healing and recovery following surgical procedures. Whether it’s a facelift, breast augmentation, liposuction, or any other cosmetic surgery, the proper care after the operation significantly impacts the final results. Here are some essential aspects of plastic surgery postoperative care.

First and foremost, following the surgeon’s instructions is paramount. They will provide specific guidelines tailored to the patient’s procedure and individual needs. These instructions may include details on wound care, medication management, and any restrictions on activities. Adhering to these instructions diligently is essential for promoting proper healing and minimizing complications. When working with a private caregiver it is important to share any plastic surgery postoperative care instructions.

Proper wound care is vital in plastic surgery postoperative care. Keeping the incision sites clean and dry is crucial to prevent infections. Patients are often advised to clean the incisions with mild soap and water, apply antibiotic ointment as directed, and cover them with sterile dressings.

Regular follow-up appointments with the surgeon allow plastic surgery patients to monitor the healing progress and address any concerns.

Pain management is another critical aspect of plastic surgery postoperative care. Surgeons may prescribe pain medications to alleviate discomfort during the recovery period. Patients need to take medications as prescribed and communicate with their doctors about their pain levels.

Additionally, applying cold compresses and keeping the surgical areas elevated can help reduce swelling and pain.

Proper nutrition and hydration are essential for healing after plastic surgery. Eating a well-balanced diet rich in vitamins, minerals, and protein supports tissue repair and recovery. Staying hydrated aids in flushing out toxins and promotes healthy circulation.

Physical activity should be limited as advised by the surgeon. It’s crucial to avoid strenuous activities and heavy lifting during the initial recovery phase to prevent complications and ensure the incisions heal properly.

Finally, emotional support plays a significant role in the postoperative period. Undergoing plastic surgery can be an emotional experience, and patients may benefit from the support of loved ones or even professional counseling if needed.

Plastic surgery postoperative care is a comprehensive process that involves following the surgeon’s instructions, maintaining proper wound care, managing pain, practicing good nutrition and hydration, limiting physical activity, and seeking emotional support. By adhering to these guidelines, patients can optimize their recovery and achieve the best possible outcomes from their cosmetic surgery procedures.

Do you need Plastic Surgery Postoperative care and assistance?

If you are asking yourself if you need plastic surgery postoperative care and support, chances are you do. The best person to ask is your physician. Often the answer is a resounding yes. For many, plastic postoperative care is provided by a spouse, family, or friend. Arrangements for postoperative support should be made well in advance.

How much postoperative support do you need?

Once again, your physician is the one best suited to answer this question. Typically plastic surgery postoperative care is required for the first 24-48 hours. This is to provide support as needed, monitor for complications, and assist as necessary to avoid injury.

What can your caregiver assist with?

Your plastic surgery postoperative caregiver can assist with many things. The goal is to help you remain independent after your procedure and help to insure you are supported and safe while recovering from anesthesia, and the procedure itself.

Your physician will most likely have standard post-operative instructions. These are important to share with your postoperative caregiver. They will share what to expect, complications to monitor for, activity limitations, when to contact the physician and other important information.

There are limitations to what your postoperative caregiver can assist with. These are often things that require a higher skill level such as an RN. Fortunately, by working together with your physician’s office there is often an RN available as a resource.  Abby Services also has an in-house RN to help you plan and guide your postoperative care.

Our nurse, Scott Strachan has the experience and training to help families develop a personalized care plan that addresses the unique needs of plastic surgery postoperative patients. With our support and input, you can develop a postoperative care plan that delivers stability, support, and quality of life.

Together with postoperative instructions provided by your physician, we can work with you to develop clear expectations and guidelines for your private care provider

By considering your specific situation combined with your physician’s information, we can help to ensure the in-home caregiver you work with has the tools necessary to be sure you have a safe and speedy recovery.

Your caregiver can assist with the following:

• Bathing
• Dressing
• Transfers
• Fall Prevention
• Laundry
• Grooming
• Homecare
• light housekeeping
• incontinence
• Transportation
• Errands

Do you need short term or extended postoperative caregiver support?

Short or long-term, an Abby Services plastic surgery post-operative caregiver can help. The caregivers we refer can assist you with all of your in-home caregiver needs short or long-term.

Caregivers are available for as little as 4 hours one time, all the way through 24/7, to provide in-home support for as long as you need.

Often we simply do not know how much postoperative support we need or for how long. That’s why it’s important to have the backing of Abby Services to help ensure you have access to the best caregivers in Fort Myers and Cape Coral.

How to arrange for plastic surgery postoperative care.

Should you need the support and assistance of a plastic surgery post-operative caregiver you simply need to call Abby Services at 239-590-0861. Our professionals can answer any questions you have and provide you with the resources to get the help you need.

All arrangements can be made by email. You will need to complete a service agreement and provide payment. Abby Services accepts all major credit cards, or ACH payment using your checking account.

The following are plastic surgeons in the Cape Coral and Fort Myers area we are proud to have worked with:

• Prendiville Facial Plastic Surgery
• Garramone Plastic Surgery
• John D Ritroski MD

Rehab Discharge – Hospital Discharge
Fort Myers – Cape Coral

Are you planning an upcoming rehab discharge or hospital discharge in Fort Myers or Cape Coral? Abby Services can help make sure you are safe at home with the support of a private in-home caregiver.

Even under the best of circumstances a hospital stay and/or rehab stay can be challenging, especially when returning home. What was once a normal part of the day – bathing, cleaning, cooking, doing errands, moving around the home, walking the dog – can be temporarily or permanently affected.

For some, facility-based care may be the only option due to the increased level of care required. The thing is, just about everyone wants to age in place. Sometimes in order to return home, major changes will have to be made after a rehab discharge.

Planning for what comes next should begin as soon as possible (not at the time of rehab discharge). While in the hospital, and in a rehab facility, you will have access to resources that are much harder (if not impossible) to access once you go home.

Be sure to make the most of these resources. This guide is for a patient or their loved ones to help plan and consider the questions they should be asking when considering a rehab discharge:

Questions for the hospital’s team and for your loved one’s primary physician:

• What is my loved one’s prognosis?
  • This can be a difficult question to ask and has to be tempered with both optimism and the reality of the situation.
• How long (after surgery or treatment) do you anticipate she will remain in the hospital?
• When do you anticipate a hospital or rehab discharge?
  • A great follow-up is what conditions need to be met to ensure a safe discharge.
• How will you coordinate the evaluation and reporting of my loved ones’ condition now? When do they enter rehab? When do they go back home after their rehab discharge? If not you, what physician will be managing their care?
• How will you coordinate the rehab discharge with the rehabilitation center? With the Medicare home care services that I will hire?
  • It is important to remember that you have a choice in the Medicare Home Health you choose and receive. DO NOT HESITATE TO CALL AROUND. Some hospitals have incentives to refer to specific services that may not best meet your needs.
  • Abby Services is happy to recommend Medicare Services we are working with.

Questions for the hospital discharge manager or social worker about your hospital discharge or rehab discharge.

• What are my loved one’s rehabilitation facility options? Be sure to request more than one.
• If your loved one is coming directly home for rehab, what do you have to know and do as a family caregiver?
  • Abby Services has private caregivers who can help support an individual returning home after rehab discharge to help them remain independent. Be sure to ask what level of support is recommended.
  • Often the level of support recommended is high. That is to be sure your loved one is safe and has the support they need. With Abby Services once home the patient and their family can evaluate the situation and tailor their hours to best suit and meet their needs.
• Or, if they will go first to rehab and then to their home, what are my options for hiring home health care support?
  • Abby Services private caregivers can support clients while in rehab as well as upon their return home.

Before your loved one is transferred to a rehab facility

• Research the quality and reputation of the rehab facility. Do they carry state and national accreditation? What is their track record – both positive outcomes and negative incidences?
• Tour the facility if possible and meet with the administration and caregivers. If possible, talk to family members of patients currently receiving services in the facility.
• Understand how this care will be paid for and for how long.

The transfer from hospital to rehab

• Talk to your loved ones, and prepare them for their move from the hospital to rehab.
• Gather a few easily portable items of comfort from their home (a favorite blanket, book; small pictures of family, etc.) to take to their room at the rehab facility.

After your loved one enters rehab

• Talk daily with your clinical contact at the rehab center to determine your loved one’s progress, and to stay abreast of the projected timeframe for rehab discharge. Rehab discharge planning should start upon admission. When do they anticipate rehab discharge? What benchmarks are needed for a  safe rehab discharge? How are they working to accomplish this goal?
• Work with your family to visit your loved one in rehab as frequently as possible, to gauge both their progress and the quality of care they are receiving. Try to meet with the rehab facility’s attending physicians, physical/occupational/speech therapists, and floor nurses at each visit.
• Scent plays a big role in an individual’s well-being. Some facilities may have a distinct scent. Seek products that create a calming and peaceful environment.
• Sound also is an inevitable part of rehab. Your loved one needs rest. Consider getting a sound machine, earplugs, or sound-isolating headphones, to mask the noises in the hall, or their roommate so that they can get the rest they need.
• In anticipation of your rehab discharge begin evaluating home care service options as soon as your loved one enters the rehab facility. Call, email, and interview prospective home care services to determine if they are a good fit.
  • Remember that there are typically 2 types of home care services available.
    • Medicare: This is paid for by Medicare, and can typically cover services such as RN visits, PT, OT, and wound care.
    • Private: Private services pick up often when Medicare lets off and can be there at your direction and discretion to help with personal care and assistance such as bathing, laundry, homemaking, and meal prep.
• Before your loved ones’ rehab discharge, their doctor may need to do a medical assessment to determine in-home care needs based on the activities of daily living, or ADLs.
• Based on the doctor’s needs assessment, work with the home care agency you select to develop a plan of care for your loved one: What services will be provided, by whom, and how frequently? What portion of home care could be covered by government programs? What resources does the family have to pay for – what will be the out-of-pocket expenses? Based on these factors, develop a care plan and schedule.

How much of my loved one’s rehab stay does Medicare cover?

Medicare does not typically cover long-term care in a rehab facility unless there are extenuating circumstances. Medicare recipients must first be in a hospital for a minimum of three nights, and receive a doctor’s order, to have Medicare cover care in a skilled nursing/rehabilitation facility.

Medicare will pay for your loved one’s stay at a rehab center if they continue to benefit from receiving skilled services. If the patient has reached a level of mobility or health equal to their baseline health condition before the event that sent them to the hospital, Medicare typically will not continue to cover skilled nursing or rehabilitation services within the facility reinforcing the need for rehab discharge planning.

Families whose loved ones have their short-term Medicare benefits expire have three choices:

• Get a doctor’s evaluation and apply for an extension of Medicare benefits.
• Pay for additional nursing/rehab facility care out-of-pocket.
• Or make sure that professional home care services are in place before the loved one returns home.

Coming home after rehab discharge.

Adjusting to the “new normal” is never easy. Bringing a “stranger” in to provide home care can put additional strain (at least initially) on both the elderly loved one and her family.

Here are ways you can help ease the transition:

• Be sure prior to discharge you work with the therapists and discharge planners to evaluate and order any necessary specialty products and or adaptive devices.
  • Common things are a bedside commode that can be used as a shower chair, walker, wheelchair, specialty bed, etc….)
• Make sure that the professional caregiver is a good match for your loved one. This is a primary responsibility of the home caregiver service.
  • At Abby Services we liken our service to a match-making service. Just like dating, you may not marry the first person you date. If you find your caregiver is not a good fit simply request a replacement.
• Work with the home care agency to evaluate the safety of your loved one’s home. Pinpoint areas of risk: unsecured rugs, floor transitions from room to room, security of bars and railings, seating arrangements, access to the kitchen and bathroom.
• If necessary, hire home improvement contractors to add ramps, railings, and other supports, widen doorways, change sink, toilet, and tub configurations to improve access and safety.
• Consider setting up home security and remote monitoring systems that enable you to stay in touch with your loved one through a video link or a phone app.
• Work with the caregivers the home caregiver service has matched you with. Tell them about your loved one’s likes and dislikes (food, home care, entertainment, etc.).
• At Abby Services we always recommend clients define in their own words what their expectations are so that we may share these expectations with their caregivers.
• Before your loved one arrives home, arrange for the caregiver(s) to meet them at the hospital or rehab facility for a get-to-know chat.
• Ask for the caregiver to be present in the home when your loved one returns from hospital or rehab
• Make time after work or on weekends to spend time with your loved one and her caregiver. Listen to both, separately, to assess how the relationship is progressing. 

Final tips

Making the transition from hospital to rehabilitation to home care can be extremely challenging, especially if the health, mobility, and mental state of your loved one have changed profoundly. Through the process, remember:

• Make a list of questions before each meeting. There are no bad/stupid questions.
• Anticipate and plan the next phase in your loved one’s care long before you approach that step.
• Keep a notebook and record your conversations with physicians, discharge specialists, rehab experts, and the home care professionals you hire.
• Listen to both your loved ones and their caregiver to make sure they are well-matched.
• Give yourself permission to make time for yourself – to rest and recharge. Your elderly loved one and your family will benefit.

Dont forget you are not alone. Abby Services is here to help. Just call to speak with our RN who can help answer questions and guide you down the best path. 239-590-0861

In-home rehabilitation means receiving physical therapy, occupational therapy, or speech therapy at home, usually through a Medicare-certified home health agency after a hospital or rehab stay. Here is what surprises most families: those skilled therapy visits are short and intermittent, often 30 to 60 minutes a few times a week. Everything in between, the meals, the exercises you were told to practice, getting to the bathroom safely at 2 a.m., is up to the patient and family. That gap is where a private caregiver comes in, and it is often the difference between a recovery that sticks and a return trip to the hospital.

What In-Home Rehabilitation Covers

The goal of any rehabilitation program is to increase a patient’s level of independent functioning. When rehab moves home, a home health agency typically provides some combination of:

• Physical therapy (PT): reducing pain and improving strength, balance, and movement
• Occupational therapy (OT): regaining independence with daily activities like dressing and bathing
• Speech and language therapy: help with communication, swallowing, and eating
• Skilled nursing visits: wound care, medication management, and monitoring

These services are valuable, and Medicare covers them when a doctor orders them and the patient meets the requirements. But they are visits, not coverage. The therapist leaves, and the rest of the day begins.

The Gap Between Visits Is Where Recovery Happens

Therapists will tell you themselves: progress depends on what happens between appointments. Patients recovering at home still need to eat well, move safely, practice their prescribed exercises, keep up with medications, and avoid the falls and setbacks that undo weeks of work. For someone living alone, or with a spouse who has limitations of their own, that is a lot to manage.

A private caregiver fills that gap. Working under your direction, a caregiver can:

• Encourage and assist with the home exercise activities your therapist prescribed
• Prepare nutritious meals that support healing
• Provide standby assistance with walking, transfers, and bathing while strength returns
• Handle laundry, housekeeping, and errands so energy goes toward recovery
• Provide medication reminders and report concerns to family
• Drive to outpatient therapy and follow-up appointments

To be clear about roles: a private caregiver is not a therapist and does not provide skilled therapy. The caregiver reinforces the plan your licensed therapists created, with hands-on personal care and daily living support that skilled visits do not include.

When In-Home Rehab Follows a Facility Stay

Often patients discharged from a hospital are not ready to go straight home and spend time at a rehabilitation facility first. Even the best inpatient rehab stay ends, sometimes because the patient has plateaued, and sometimes simply because the covered days run out. Either way, most people leave rehab improved but not fully recovered.

Arranging caregiver support before that discharge, not after, is one of the most effective ways to prevent a readmission. Our hospital and rehab discharge support page covers how to plan that transition, and if the recovery follows an operation, see our guide to after-surgery home care. For stroke recovery specifically, where rehab often continues for months, caregivers experienced with stroke recovery support are available as well.

Support That Shrinks as You Recover

One advantage of private care during rehabilitation: it scales down as you improve. A patient might start with daily visits, drop to three mornings a week as strength returns, and end care entirely once independence is back. You set the schedule, you can decrease the level of support as you continue to recover, and you stay in control of the care the whole way.

Who Pays for What

This is where families most often get caught off guard:

• Medicare may cover the skilled services, the PT, OT, speech therapy, and intermittent skilled nursing, when eligibility requirements are met. Medicare does not typically pay for private caregiver services like personal care, homemaking, or companionship.
• Long-term care insurance often does cover private caregivers. We help families navigate the paperwork; see our long-term care insurance support page.
• VA benefits may help veterans and surviving spouses offset the cost of in-home care.
• Private pay is the most common option, and because you only pay for the hours you request, costs drop as recovery progresses.

If you or a loved one is completing in-home rehabilitation in Fort Myers, Cape Coral, or anywhere in Lee, Collier, or Charlotte Counties, Abby Services can help you find a screened, credentialed private caregiver to support the recovery. We have been helping Southwest Florida families since 1997, and contacting us before discharge gives us the best chance of having care in place the day your loved one comes home.

Frequently Asked Questions

Sources

• Medicare.gov: Home Health Services Coverage
• MedlinePlus: Rehabilitation