4 Tips to Help Your Terminally Ill Loved One Prepare Financially

If you have a loved one who was recently diagnosed with a terminal illness — such as inoperable cancer or Alzheimer’s disease — your life has been turned upside down. Even if your family member struggled with their health prior to the diagnosis, it doesn’t make the situation any easier. In addition to coping with the sadness and anxiety of this difficult time, your loved one will likely need support in preparing for the future financially. This is especially true if the illness came on suddenly or at a younger age.

Elite Home Health & Hospice shares four things that you can do to provide support and assistance to your terminally ill family member.

Handle all tasks and communication with the utmost compassion

Above and beyond anything, show the highest degree of compassion and care in all interactions. As you handle tasks that can be emotional for both you and your family member, be aware of how you are communicating. Avoid showing too little emotion, as this can come off as unfeeling and hurtful. Aim to be a steady source of confidence and love through these challenging end-of-life tasks.

Find ways to help your family member pay for their medical bills

Expenses associated with terminal illnesses are often astronomical. Bills that amount to hundreds of thousands of dollars are often commonplace in these situations. Medications that provide some level of relief from pain and suffering can cost hundreds or even thousands of dollars for every refill. At a time when your loved one is already experiencing such massive distress, the last thing they should have to think about is paying their medical bills.

If your loved one needs extra funds to pay for their prescriptions and medical care, there are options available for most individuals. One popular choice is home refinancing. Refinancing either your home — or your family member’s home — can quickly free up equity for immediate expenses. Research the best refinance rates to ensure that this is the option for you.

Establish end-of-life arrangements

Another incredibly important set of tasks to handle as soon as possible are end-of-life arrangements. This includes everything from creating power of attorney, to planning and funding funeral arrangements. Most people plan to fund funeral arrangements via life insurance, though you may have to change policies after a diagnosis. In such an instance, it’s critical that you fully understand the terms of the new policy and make sure not to cancel the old policy until coverage begins.

When signing so many documents, one option to consider is using an online tool for digital signing. This makes it easier to provide legal signatures for important documents without having to worry about printing and mailing.

It’s also important to plan for or work through selling or closing a business your loved one owns. This can be a relatively simple matter if ownership is in a corporation held in stock. Other business structures can be more complex and may require legal assistance.

Of all of the things you will need to help your family member with, this will almost certainly be the most emotionally challenging. Prepare yourself for these tasks by reaching out to your support network of friends and relatives. Also, if you find yourself struggling most days, consider working with a counselor to cope with your feelings.

Ensure that their will is up-to-date

Revisiting your loved one’s will is a particularly critical task — especially if they have a considerable amount of assets. Without proper designations, some or all of their property could go to the state. Hire an experienced attorney to guarantee that the will is updated in such a way that is legally binding.

Although it can be next to impossible to think about anything other than your terminally ill loved one at this time, addressing the above tasks is an absolute must. Part of honoring your family member is doing everything you can to ensure that their last wishes and requests are granted. As difficult as that is, knowing you helped your loved one when they needed it most can be a great source of comfort in the years ahead.

For trusted home health, palliative care, and hospice servicer, visit Elite Home Health & Hospice today!

Is Telehealth really a good option?

You might wonder if telehealth really is a valid option for seeking healthcare and the opinion of a professional if they are unable to see you in person. Here are some guidelines we use when considering if telehealth makes sense for our patients.

Constitutional: e.g. well-nourished, well-developed, well-appearing, Vitals

Ears, nose, mouth, throat: e.g. normocephalic, atraumatic, external ears normal
by inspection

Eyes: proptosis, extra-ocular eye movement intact, nl sclerae, conjunctivae not
injected

Neck: visible goiter, range of motion of neck

Respiratory: comment on increased respiratory effort

Cardiovascular: patient can palpate PMI

Chest/Breast: e.g. gynecomastia, symmetry

Gastrointestinal: e.g. no caput medusae, no tenderness with self-palpation in
supine position

Genitourinary: visual exam of external genitalia

Musculoskeletal: ROM (active & passive), nails/digits

Lymphatic: Large lymph nodes can be visible

Skin: rashes, ulcers, varicose veins

Psychiatric: anxiety level, affect, memory, tangential conversation

Neurologic: motor deficits, select cranial nerves (e.g. sticking out tongue)

Systems that allow us to gather crucial data, like vitals, facilitate the option for telehealth. Elite Home Health & Hospice pursues telehealth by issuing a system which can support weight tracking, blood pressure recording, pulse oximetry, and heart rate. Telehealth requires patients to participate in their health care assessment, sometimes by being hands on, such as depressing the skin in the shin to show edema.

Using the camera on a phone can facilitate assessment of foot ulcers: Have the patient put the camera on the floor and show you
the bottom of their feet, top of scalp, nape of neck (acanthosis), close-ups of body areas that trouble them, neurologic and musculoskeletal exams: Have the patients move their extremities for passive and active ROM etc, and even GI: self-palpation under supervision may help document rebound, guarding etc, and using a coin/ruler can help create context of the size of a lesion.

Telehealth is a brand new world in healthcare. We are excited to participate in the first steps and bring care to our communities in new ways.

5 Ways Telehealth Increases Patient Activation

Elena Muller, MPH

For a patient to achieve good health, patient engagement and activation is crucial. This blog explores the difference between patient engagement and activation and discusses how telehealth can help improve patient activation, and ultimately, health outcomes. 

What is Patient Activation?

Patient activation and patient engagement are not one in the same. Patient activation falls under the umbrella of patient engagement. According to Dr. Hibbard, MPH, “patient activation emphasizes patients’ willingness and ability to take independent actions to manage their health and care” while “patient engagement denote[s] a broader concept that includes activation; the interventions designed to increase activation; and patients’ resulting behavior, such as obtaining preventive care or engaging in regular physical exercise.”

The Power of Patient Activation

Patient engagement and patient activation are essential for good health.  An activated patient is more likely to engage in preventative behaviors such as immunizations and annual appointments, adhere to their medications, understand their health, and have the knowledge to understand and navigate the healthcare system.

Patient education from provider

The Patient Activation Measure and How Telehealth Can Help

Many providers use the Patient Activation Measure (PAM), an 100 point scale that determines how engaged a patient is with their own health. The survey includes 22 items that are weighted to comprise the 100-point scale. Dr. Hibbard and her colleagues who developed the survey, also released a shortened, 13 item survey. Many providers collect survey responses online through the patient portal, or when the patient comes to an in-person visit.

The PAM evaluates a patient’s ability to:

  • Self-manage illness or problems
  • Engage in activities that maintain functioning and reduce health declines
  • Be involved in treatment and diagnostic choices
  • Collaborate with providers
  • Select providers and provider organizations based on performance or quality
  • Navigate the healthcare system

This tool helps providers identify the activation level of their patients, and tailor care accordingly. It helps providers “meet patients where they are.” 

Telehealth: The Best Patient Activation Tool

Telehealth helps improve patient activation by providing patients with tools to actively engage in their own health. It offers providers the tools to collaborate with their patients, and forge partnerships, as opposed to offering care at just one point in time.

When telehealth is leveraged correctly, behavior change is the result. Behavior change results in a more engaged patient, which, in turn, leads to improved outcomes, better health, and reduced cost of care. Telehealth involves patients in their own healthcare. 

“Tell me and I forget, teach me and I may remember, involve me and I learn” 
– Ben Franklin

5 Ways Telehealth Increases Patient Activation

Telehealth:

  1. Meets the patient where they are

Every patient is different and requires a unique patient activation strategy. What one patient needs to engage in their care is likely different than their neighbor. Every telehealth care plan can be customized to fit the unique needs of each patient. For example, a patient struggling with medication adherence can leverage medication reminders, while a patient struggling with condition understanding can leverage condition-specific education and symptom surveys.2. Provides more opportunities for patient-provider collaboration

Virtual visits enable patient-provider communication beyond just one point in time. This is important because the creation of a partnership between the patient and provider is facilitated. Telehealth improves access to healthcare—it is not location dependent. 3. Helps the patient understand their health holistically

For a patient to achieve good health, a full picture of their condition is essential. For the provider, understanding their patients’ health holistically allows them to point to what may be contributing to poor outcomes and intervene or customize the care plan accordingly. A patient that understands their health holistically has more control of their health outcomes because they understand the many factors at play—activity, diet, sleep, symptoms, medication, stress, etc. Telehealth and remote patient monitoring allow the patient to track their condition over time, helping them note and understand important trends. 4. Offers opportunities for education

Health literacy, a patient’s ability to use, obtain, and process certain health information is one of the key predictors of whether a patient is activated or not. A patient who is health literate is likely motivated to take control of their health, understands the steps to doing so, and has the ability to obtain the resources they need to effectively manage their condition. Telehealth improves health literacy by providing tools for education, including videos, written materials, and teach-back quizzes. Through telehealth tools, the provider can push out condition-specific information to the patient, that the patient can engage with on their own time. The provider can also offer more opportunities for 5. Improves patient adherence to their care plan

Patient adherence, “the extent to which a person’s behaviour- taking medication, following a diet and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider” (WHO), is often quite low. In the United States, 1in 5 medications go unfilled and half of patients do not take their medication as prescribed. Patient adherence, however, goes beyond medication compliance. It relates to lifestyle changes, diet, showing up for doctor’s visits, etc. Telehealth can help facilitate the behavior change needed to achieve patient adherence by providing tools for medication reminders, activity tracking, nutrition education, appointment reminders, and more. 

These benefits are really just the tip of the telehealth value iceberg. Patients across their patient journey can see the benefits of telehealth in different ways, what’s most important is patient-centric care is at the center of care delivery.

The Activated, Discerning Patient

People want to be in the driver’s seat of their own health. They want to understand how to prevent poor outcomes, and how to self-manage their conditions. By offering digital patient activation solutions, providers have the opportunity to help their patients reach their healthcare goals in a more convenient, patient-centric way.

At Elite Home Health and Hospice, our goal is to provide life changing service. We believe that means identifying your goals of care and supporting those goals with the right program at the right time. We are happy to partner with Health Recovery Solutions (HRS) to support our home health patients heal and recover in the comfort of their own home.

5 Key Benefits of Remote Vitals Monitoring

Through remote vitals monitoring, clinicians can track their patient’s health in real time, take proactive steps to prevent deterioration, and identify potential health issues. This helps reduce hospital visits and readmissions while keeping clinicians connected with patients.

As the telemedicine industry continues to evolve, clinicians have access to an increasing number of clinical-grade monitoring devices to measure key vital signs remotely.

Monitoring Patient Vitals with RPM

Remote patient monitoring, also known as RPM, is a method of healthcare delivery that collects patient data outside of traditional healthcare settings using advances in information technology. As part of an RPM program, a patient’s vital signs, such as blood pressure, heart rate, respiration rate, oxygen saturation level, and temperature, are remotely monitored using digital tools and devices.

Let’s dive deeper into the five key benefits of remote vitals monitoring:

  1. Increased Access to Value-Based Care
  2. Improved Patient Outcomes
  3. Healthcare Cost Savings
  4. Enhanced Patient Engagement
  5. Increased Healthcare Provider Efficiency

1. Increased Access to Value-Based Care

Replacing the traditional fee-for-service reimbursement model, value-based care ties payment for care delivery to the quality of patient care. Implementing value-based care effectively improves patient outcomes and reduces care costs; however, it presents some challenges to the healthcare system.

Lack of resources is one of the most pressing challenges facing organizations looking at implementing value-based care. Remote vitals monitoring can help alleviate some of these challenges by helping providers increase capacity. Through virtual visits and remote vitals monitoring, providers can increase staff efficiency and focus more energy on the highest risk patients. As an average across clients, remote monitoring allows a ratio of 80 to 100 patients for every telehealth nurse.

Value-based care centers around cost-efficiency, achieving better patient outcomes, and increasing patient satisfaction. These are also the pillars of a successful remote monitoring program.

2. Improved Patient Outcomes

Checking vitals such as heart rate, blood pressure, and blood glucose levels usually requires scheduling in-person doctor visits. This can be stressful, especially for those who must take time off from work or coordinate with family members for transportation. But with remote monitoring technology, patients can share their vitals using Bluetooth-enabled biometric devices from the comfort of their homes, making it easier for patients and family caregivers to be more involved in health management, thereby improving health outcomes.

As a real-life example, patients enrolled in the remote monitoring program with Southcoast VNA are monitored daily, with clinicians responding to risk alerts based on their reported vitals and symptoms. To quickly evaluate patients and address any concerns, providers can contact patients directly via a virtual visit or text messaging.

This care model replaces at least one in-person visit a week with a virtual visit, and the additional touchpoint has significantly improved physician-patient trust and communication, while decreasing care costs and staff workload by avoiding unnecessary in-home visits.

In the last 16 months, from October of 2021 until January of 2023, the Southcoast VNA’s RPM program has achieved a low 30-day readmission rate at seven percent for 2,621 high-risk patients.

Southcoast Health Reduces In-Home Care Costs and Hospital Readmissions with Virtual Visits and Remote Patient Monitoring

Southcoast VNA saves an average of 4 in-home nursing visits leveraging virtual visits & remote patient monitoring with a 7% 30-day rehospitalization rate for 2,621 patients over the last 16 months.

LEARN MORE

3. Healthcare Cost Savings

Remote vitals monitoring can significantly reduce avoidable ER visits, unnecessary hospitalizations, and readmissions, thus reducing healthcare costs. Vital monitoring devices may help patients have a greater understanding of their disease and risk alerts can notify providers of rising patient risk. This allows physicians to have visibility into their patient’s conditions and quickly intervene—without the associated costs of a hospital admission.

Southcoast VNA was able to save an average of four in-home nursing visits annually, and generated over $500,000 in cost savings, using virtual visits and remote monitoring.

4. Enhanced Patient Engagement

In a traditional healthcare setting, once a patient leaves the doctor’s office, care delivery ends until the next visit. Practitioners lose visibility into what is happening with their patients when they are not within their sight. They can only hope that the patients are following their advice.

But with remote monitoring, this barrier is removed, and practitioners have ongoing visibility into their patient’s health condition. This can improve the patient-practitioner relationship and drive better health outcomes. It’s important to implement a program that includes multiple communication channels (text messaging, videoconferencing, phone calls) and resources to support patient engagement. Both patients and clinicians need to be fully engaged with the program to see a positive impact.

A-Guide-to-Patient-Engagement_thumbnail

The Complete Guide to Patient Engagement

A robust patient engagement strategy comes with many benefits. Two that are most notable are improved health outcomes and reduced cost of care.

View the guide 

5. Increased Healthcare Provider Efficiency

Remote vitals monitoring can help reduce ER visits and avoidable hospital readmissions, allowing practitioners to focus more of their time and energy on patients that need them the most. In the face of an ever-worsening nursing shortage, remote monitoring is key to making healthcare delivery more efficient and streamlined. Care providers can better position their staff to support the most at-risk patients, while also monitoring and educating patients with chronic conditions from afar.

Remote Vitals Monitoring: A Holistic Care Delivery Program

Remote monitoring is a critical part of the modern, value-based care model of healthcare delivery. For patients, remote vitals monitoring provides better access to care, improved health outcomes, and better quality of life. And for healthcare providers, remote monitoring technology allows improved chronic disease management, decreased disease exacerbations, increased productivity for clinicians through improved workflows, and reduced healthcare costs.

Elite Home Health & Hospice is grateful to be a partner with HRS Health Recovery Solutions and offer a comprehensive solution for vitals monitoring. For more information, check out https://www.healthrecoverysolutions.com/blog/5-key-benefits-of-remote-vitals-monitoring

One of your choices as a patient is to identify the members of your team. Elite Home Health & Hospice is pleased to partner with you and your physician to create a comprehensive care plan around your goals of care.

Thyroid Health and the Aging Process

The thyroid, more specifically the thyroid gland, is part of the endocrine system. The gland is responsible for producing two hormones, the thyroxine (T4) and the triiodothyronine (T3). The thyroid sits just below the voice box and is made up of a right lobe and a left lobe. The thyroid is involved in the metabolism processes of the cells. Disorders of the thyroid can result in too much (hyperthyroidism) or too little production (hypothyroidism) of hormones.

In the elderly, thyroid disease can be confused with other conditions given the symptoms that are present and the physical changes a person may experience. Common symptoms of hyperthyroidism include weight loss, heat intolerance, anxiety, and gritty eyes. Common symptoms of hypothyroidism include tiredness, feeling cold, weight gain, difficulty concentrating, and depression. With aging, individuals may only experience one or two symptoms.

Daily medications are often prescribed for the treatment of thyroid disease either supporting hormone production or inhibiting hormones. Consistency with a prescribed medication regimen is critical to effectively managing thyroid disease. Home health services are available to support understanding thyroid disease in the elderly, creating effective medication management regimens, and supporting healthy lifestyle choices around weight changes and energy levels for self-care.

For more information, check out these resources at

Older Patients and Thyroid Disease

https://www.btf-thyroid.org/what-is-thyroid-disorder#:~:text=The%20thyroid%20gland%20is%20an,your%20body%20to%20work%20normally.

Home Health and Glaucoma

Managing progressive illnesses, such as glaucoma, require proactive interventions. According to Johns Hopkins Medicine (https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-tips-for-living-better-with-glaucoma), individuals diagnosed with glaucoma can prevent progression by

  1. adhering to medications
  2. avoiding falls and accidents
  3. maintaining a healthy lifestyle
  4. reading
  5. creating a support team

Home health services support patients by creating positive routines for the care and management of their person and their disease (https://preferhome.com/senior-resources/common-senior-illnesses/glaucoma/). Because glaucoma can impact the way an individual processes light vs. dark, contrasts, transitioning from different lit rooms, or have sensitivity to light or glare, home health professionals, such as occupational therapists, are uniquely trained to examine and process these environmental challenges.

Our goal is to keep patients in their chosen living environment. Proactively setting up systems helps make this a reality.

Thank you for 2022!!

Here at Elite, we are so grateful for the opportunity to serve the communities we live in and the people we call neighbors.

In 2022, Elite offered home health and hospice services in:

Asotin County

Garfield County

Nez Perce County

Latah County

Clearwater County

Idaho County

We were also able to offer palliative services in:

Asotin County

Nez Perce County

Clearwater County

Latah County

Our mission is the same

Life-changing service

Thank you for letting us come into your homes to provide you care and support!

Happy New Year from all of us at Elite!

What is the role of Palliative in Chronic Kidney Disease?

“End stage renal disease is a progressive, debilitating, chronic illness requiring nursing and medical interventions. The development of the disease affects quality of life, potentially influencing physical and mental health, functional status, independence, general well-being, personal relationships and social functioning.” (Cleary et al., 2005)

Chronic kidney disease is a complex chronic condition. Given the complexities of other comorbidities, close monitoring and mitigation of symptoms related to the interplay of other chronic conditions and managing multiple medications is a complicated process. Our goal in palliative is to support the patient’s quality of life as an integrated approach. Sharing information with the primary provider to support symptoms is measured by the patient’s self-rating of quality of life. Patients in palliative are still pursuing curative treatments, and they are engaging in meaningful activities in spite of having progressive conditions.

Weekly Pulse for March 28, 2022

Home Health
(Therapy)
Start Date		Hospice
(Nursing)
Start Date
Clarkston3/303/29
Lewiston3/293/29
Moscow3/313/29
Orofino4/13/31
***Start Dates are contingent on receiving a complete referral***

Clinical Focus

We want to take a moment and recognize the unique field of occupational therapy. April 1st launches Occupational Therapy Month. At Elite Home Health & Hospice, we are lucky to have a core OT team that supports all of our service areas.

The profession of occupational therapy is evidence-based, client centered, and cost-effective. The field has pioneered changes in policies, environments, and systems to support individuals with unique needs. As a profession, OTs are integral in working with patients and systems to produce effective outcomes through culturally responsive and customized services. As a field, OTs are intentionally inclusive and equitable, embracing diversity within the practice. For more information, visit AOTA.org. 

Question Corner

What is an Occupational Therapist (OT)?

Occupations are the activities people of all ages need and want to do, such as making a meal, dressing, grooming, managing medications, driving, returning to pleasure activities, and participating with family and friends. The profession pursues treatment through the lens of “What matters to you?” NOT “What’s the matter with you?” OTs consider the complexities of a patient’s condition with their desired activity in the preferred environment. This intervention may result in adaptations and modifications which may change over time.

An OT will perform a comprehensive assessment and identify treatment targets and interventions that meet a patient’s desired outcomes. OTs often collaborate with members of nursing, physical therapy, and speech therapy to create a comprehensive plan to meet the patient’s needs.

If you have questions about Elite’s Occupational Therapy team, send us an email at info@EliteHHH.com 

People to know

Clarkston Liaison – Angie (509) 780-8097

Lewiston Liaison – Beth (509) 254-1381

Moscow & Orofino Liaison – Scott (509) 234-3102

Business Development – Ashley (509) 843-7605

What is the role of Hospice in Chronic Kidney Disease?

“End stage renal disease is a progressive, debilitating, chronic illness requiring nursing and medical interventions. The development of the disease affects quality of life, potentially influencing physical and mental health, functional status, independence, general well-being, personal relationships and social functioning.” (Cleary et al., 2005)

Kidney disease involves complex care management for multiple systems. The role of hospice is meant as a support for the patient and their family as they approach end-of-life. Identifying components that meet the patient’s desired quality of life and creating plans to support these desires is the primary purpose of an interdisciplinary team. The care team is comprised of nursing, social work, and chaplains. We also provide bath aide support and massage therapy for creating comfort and non-pharmacological methods of pain reduction. Because of our unique status as a home health and hospice agency, we also can provide consultation from physical therapy, occupational therapy, speech-language pathology, and medical dietitian.