Before my co-owner and I started Support For Home In-Home Care, we worked in the high technology industry. I “retired” — the quotes are an ironic reference to the fact that when some people retire, they stop working! 🙂 — from Intel, after 18 years, as an IT Director. The Boss was also a senior manager at Intel, spending 13 years there. At Intel, there was a running joke that to be successful there you had to be a little bit arrogant. There was probably just a bit of truth in the joke.
In elder care and home care, however, there is absolutely no room for arrogance or biases. There is also no simplistic formula which distinguishes good non-medical home care agencies from bad ones. The really good agencies — the really good owners — understand this fact.
The other day, we came across some Tweets (which fed a Facebook account) from someone that we thought really grasped this truth. We were really a bit shocked to learn otherwise.
Basically, the Tweets were taking the position that, to be a good home care agency, client assessments have to be done by an RN. Frankly, this is wrong on a lot of levels, starting with the fact that some of the poorer non-medical home care agencies with which we are familiar are actually owned by nurses. On the other hand, two that we respect in this region are owned by passionate, dedicated non-medical business professionals.
In those two cases — as well as for Support For Home — most assessments are done by the owner or a non-nurse employee. In our case, our Client Services Manager is a gerontologist by academic training. She and I do all client assessments, and — boy, I hope this does not sound arrogant! 🙂 — we think we do a good job and provide very good home care, as a result.
Now, why do I believe we are able to do at least as well as an RN in performing those assessments? Because we are providing non-medical home care. We are focused on non-medical (but critical) Activities of Daily Living (ADLs and Instrumental ADLs):
- Personal Hygiene / Bathing
- Dressing and Undressing
- Transferring (e.g., from bed to standing to chair)
- Continence (control of urine and bowel)
- Toileting – Ability to use restroom
- Ambulation / walking
- Food preparation
- Taking medications as prescribed
- Ability to handle finances
As you can see, these ADLs and IADLs are non-medical. We are not talking about vital signs or injections — in fact, those are proscribed for non-medical home care agencies. The specialized training that RNs get is great, in a clinical setting, but it does not mean they understand what a diabetic diet should contain or how to deal with dementia (trust me, I have lots of data on these) or many other needs that our home care clients have.
So, to return to the theme — arrogance about one’s credentials is not an asset in managing and providing non-medical home care. In fact, it may blind one to what can be learned from others — including great client service. Are there RNs who run great home care agencies? You bet. Are there old, retired IT geeks who can do it too? Well, I don’t want to sound arrogant, … 🙂
As always, best wishes. Bert