Tuesday, December 29, 2009

Helping to manage the older years

Getting older is one of the inevitable facts of life. And there are going to be a lot more older people. That's an equally inevitable course of the demographic of today's Ireland, which suggests that the number of over-65s is going to double in the next 10 years.

The third inevitable is that as we grow older, we can find it more difficult to look after ourselves.

"It used to be that there were only two choices for people in that position, moving into one of their children's home, or to a nursing home," says Amanda Bohan, who has just opened a new business based in Kilcullen which offers a third alternative, Home Instead. This is a personal support service for elderly people in their own home. Amanda is pictured here with her Caregiver Manager Suzanne Rankin.


'Home Instead' is a global franchise which began in America in 1994. It was brought to Ireland in 2005 and now there is a growing network of owner-managed branches of the organisation across the country. Amanda, originally from Johnstown and now living in Calverstown, has acquired the franchise for County Kildare.

"I really only planned to get involved in some volunteering work with older people, when my youngest child began pre-school," she says. "But I came across Home Instead and heard that they were looking for somebody to open up in Kildare.”

With a background in environmental science and upper management in pharmaceuticals and the waste industry, it might seem an odd choice to go into Senior Care. But Amanda has always had a strong interest in the area.

“When I was going through College I used to do night work in a nursing home in Clontarf. I also used to spend time helping care for my grandfather on a farm in England, as he had Alzheimers. So I have a huge passion for Seniors.”

The initial negotiations with Home Instead involved what Amanda describes as some ‘pretty rigorous’ interviews and personality evaluations. For her own part, she wanted to be sure herself that she was prepared to give the job total commitment.

“I have to be at the end of a phone 24/7, for families who might need help at any time. But I decided that I could do that.”

The next step was a training stint at Omaha in Nebraska, USA, where Home Instead was founded. This was followed by further training in Dublin. “It’s all non-medical, and I have done all the training that the caregivers undergo. I already had the business experience, so I was then ready to go.”

Amanda is quite clear that there is a need for what she is offering, that there’s a gap in the services available because the resources available to the HSE in this sector are limited. “The emphasis now is on having older people live in their own home for as long as possible, and they can do that, with assistance.”

The Home Instead motto is to ‘assist, encourage, and stimulate’. The services offered range from companionship through light housework and meal preparation to help with personal hygiene, medication reminders, taking the client to do their shopping and to appointments.

“It can be as simple as helping them to walk their dog or complete a jig-saw puzzle, or be more complex like reminiscence activities for those suffering from early Alzheimers or dementia. That can include helping them to put together something like a family book to tell the story of themselves before they are seriously affected.”

The work, Amanda says, is ‘person-centred’. “It isn’t task oriented, and what we really emphasise is compatibility between the client and the caregiver. We have been interviewing for caregivers over the last while and there’s a huge variety in age and personality. In the work we spend a lot of time trying to match these up.”

Recruitment of people to be caregivers was on the theme ‘Special Touch Needed’. “We had a tremendous response. The danger was that we would get people who are just looking for work, but in fact we overwhelmingly got applications from people who had looked after somebody already.”

The experience gained in the global network is all available to underpin the local office’s service. Home Instead gives full training to those selected to go on their panel of caregivers. And because the business is operating county-wide, it needs caregivers in all parts of Kildare.

Amanda will spend much of her time for the next while networking with GPs, nurses, and hospitals, while scheduling and organising is carried out by Suzanne Rankin, Caregiver Manager. Living in Newbridge, she was one of 260 applicants for the job. “It turned out she had previously worked for Home Instead on Australia’s Gold Coast,” Amanda says, clearly very happy with the symmetry of it.

Every client’s requirements are different, and Amanda and her team will ensure that all needs are individually addressed. Confidentiality is absolutely important, as is continuity. “When we match up a client and caregiver, they will stay together. Older people don’t like chopping and changing.”

It is work which involves building trust, as Amanda has to satisfy the person concerned about their mother or father that they will be properly looked after by the service. “I’m passionate about it, and that is what I have to get across.”

Clients pay for the Home Instead service themselves, but there is a 41 percent allowance against tax, which is adjusted on a monthly basis. There are basically three levels of care -- companionship, home care, and personal care which can include helping during early onset of Alzheimers or dementia. Rates start at €18.90 an hour. Live-in and overnight care can be arranged on an agreed rate.

Home Instead is also available to advise on how to raise difficult subjects to older people, such as their children’s concerns about diminishing driving ability and similar worries.

Home Instead is based in the Main Street premises formerly used by Adrian Dunne’s pharmacy.

(This story was originally published in the Kilcullen Page of the Kildare Nationalist.)